Facility Evaluation Report

On 11/20/2025 at 10:50 AM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Caregiver, Marjoy Bacuyag and explained the purpose of the visit. Marjoy Bacuyag phoned the administrator, Keith Mauer to inform. The facility’s fire clearance was approved for six (6) residents in which all may be non-ambulatory. Hospice waiver approved for two (2) residents. Administrator certificate #7027929740 expires 08/08/2026. Keith arrived approximately 30 mins later.

LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of six (6) total bedrooms that 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 73 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 105 degrees Fahrenheit. 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 locked and inaccessible to residents.