Facility Evaluation Report

On 01/22/205 at 11:15AM, Licensing Program Analyst (LPA) T. Syess-Gibson conducted an unannounced 1-Year Required inspection. LPA met with Care Staff, Jose Eden De la Cruz and explained the purpose of the visit. The facility’s fire clearance was approved for five (5) non ambulatory and one (1) ambulatory residents.

LPA toured the facility with Jose De la Cruz, Care staff including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of six (6) bedrooms and three and half (3 1/2) bathrooms. four (4 bedrooms for residents, two (2) staff bedroom. All outdoor and indoor passageways are kept free of obstruction. LPA did not observe any bodies of water. A comfortable temperature is maintained at 72 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 106.0 degrees Fahrenheit. Residents’ bathrooms are equipped nonskid mats.

Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last service on 11/11/2024. Emergency Disaster Plan was last posted on 01/22/2025. First aid kit was observed to be complete. Fire drill conducted on 12/12/2024.