Facility Evaluation Report

On 06/24/2025 at 8:45 AM, Licensing Program Analyst (LPA) P. Manalo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Direct Care Staff, Gene Messick, and explained the purpose of the visit. Administrator gave authorization for staff to sign the report.

LPA toured facility inside and out including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 5 total bedrooms which 3 bedrooms are occupied by the residents and 2 bedroom is occupied by staff. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. Residents’ bathrooms are equipped with grab bars and non-skid mats. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 07/26/2024.

At 9:27 AM, LPA reviewed 1 staff record. The other 2 staff records were not at the facility for review. At 9:37 AM, LPA reviewed 3 residents records. At 11:00 AM, LPA reviewed a sample of resident’s medications.

Updated copies of the following documents were requested for facility file and are to be submitted to CCLD by 07/02/2025:

LIC 308 Designation of Administrative Responsibility