Facility Evaluation Report

On 9/18/2025 at 11:30 AM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Backup Administrator, Marjorie Osia and explained the purpose of the visit. Administrator was out of town during inspection. The facility’s fire clearance was approved for all non-ambulatory of which one may be bedridden.

LPA toured facility with Marjorie including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 6 total bedrooms which all bedrooms are occupied by the residents. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. 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 124.2 degrees Fahrenheit and 125.1 degrees Fahrenheit in room 4. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medication and sharps were not locked and inaccessible to residents.

Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 12/18/2024. Emergency Disaster Plan was last posted on 9/3/2025. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 9/15/2025.

At 12:00pm, LPA reviewed 6 of 6 residents records. At 12:35 am, LPA reviewed 3 staff records and 3 of 3 have current first aid training and associated to the facility.