Facility Evaluation Report

On 03/17/26 at 1PM, Licensing Program Analyst (LPA) D Panlilio arrived unannounced to conduct an annual required inspection. LPA met with staff (S1) and explained the purpose of the visit. LPA spoke with ADM on the phone who authorized S1 to act on her behalf and sign the reports. LPA observed ADM has a current administrator certificate# 6056379740 which expires 09/26/2027.

At 1:10PM, LPA toured the facility including but not limited to the front entrance, screening station, kitchen, bathrooms, bedrooms and common areas. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy, visitor’s logs, no touch thermometer, additional face masks and hand sanitizers were observed at the screening station. 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 76 deg F. Hot water temperature was measured at 113 deg F. Facility has a mitigation plan in place and the infection control leader is the administrator. Smoke and Carbon monoxide detectors were operational. Fire extinguisher was observed fully charged and last inspected on 01/25/26. LPA reviewed 2 staff and 4 resident files.

Updated copies of the following documents were collected for facility file:

 LIC308- Designation of Facility Responsibility

 LIC610D- Emergency/Disaster Plan including infection control plans

No deficiencies cited during visit. Exit interview conducted and a copy of this report provided .