Facility Evaluation Report

On 07/30/25 at 12:30 PM, Licensing Program Analyst (LPA) D Panlilio arrived unannounced to conduct an annual required inspection. LPA met with administrator (ADM) and explained the purpose of the visit. LPA observed ADM has a current RCFE administrator certificate# 6068070740 which expires 11/20/25. LPA observed no residents currently living at the facility.

At 12:45 PM, LPA toured the facility including but not limited to the front entrance, kitchen, bathrooms, bedrooms and common areas. ADM stated they are in the process of remodeling the home. Emergency Disaster Plan, Complaint poster, Personal rights, Cough/sneeze etiquette, proper hand-washing signs were observed posted in common areas. Facility has a sufficient 2-day perishable and 7-day non-perishable food supply. Facility has a 30-day supply of PPEs, paper, medications locked in cabinets. Comfortable temperature is maintained at 72 deg F. Hot water temperature was measured at 118 deg F. Facility has a mitigation plan in place and the infection control leader is the administrator. Inside and outside pathways were free of obstruction and fire hazards. Smoke and Carbon monoxide detectors were operational.

ADM stated she will start operating the RCFE facility once the renovation is complete.

Exit interview conducted and a copy of this report provided