Facility Evaluation Report

On 2/5/2026 starting 8:30 AM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Backup Administrator, Marjorie and explained the purpose of the visit. Administrator was unavailable. The facility’s fire clearance was approved for all six (6) residents may be non-ambulatory. There were 2 staff and 5 residents present during inspection.

Starting at 8:40 AM, LPA toured facility with Administrator including but not limited to 6 bedrooms, 3 bathrooms, kitchen, common area and backyard. The facility consists of 7 total bedrooms which 6 bedrooms are for residents and 1 bedroom is for staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 74 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in 2 of 3 residents’ shared bathroom was measured at 114.0 and 107.1 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. Sharps were locked and inaccessible to residents.

Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 4/15/2025. Emergency Disaster Plan was last posted on 1/12/2026. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 1/10/2026.

At 9:25 AM, LPA reviewed 5 residents records. At 10:00 AM, LPA reviewed 4 staff records.