Facility Evaluation Report

Licensing Program Analyst (LPA) Carol Fowler conducted an unannounced 1-year required visit on 7/22/2025 at 2:15PM. LPA met with Administrator, Sujan Gautam. The Administrator currently holds a certificate (#7021173740) that expires on 12/05/2027. The facility’s fire clearance was approved for 6 residents, 4 non-ambulatory and 2 ambulatory.

LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 5 total bedrooms which 1 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. Hot water temperature in the shared residents’ bathroom was measured at 105 degree Fahrenheit. All toilets, hand washing, and bathing are safe, sanitary and in operating condition. The supply of extra hygiene was available for residents. There is a minimum of 7-day non-perishables and 2-day perishables foods.

Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 9/07/2024. Emergency Disaster Plan was last posted on 07/22/2025. First aid kit was observed to be complete.