Facility Evaluation Report

Licensing Program Analyst (LPA) Daiquiri Boyd arrived at the facility unannounced to conduct a required annual visit. LPA was granted entry by caregiver staff and explained the purpose of the visit. Assistant Administrator Mario Ramos arrived at the facility soon after to complete this annual visit.

The residence was set at 78 degrees F temperature and free of passageway obstructions inside and outside. LPA observed six bedrooms in the residence. Residents' rooms were toured and inspected. Rooms were found to be clean, and furnishing was in good condition. Hot water temperature was measured at 108.9 degrees F. A test of the smoke alarm and carbon monoxide system was conducted and found to be in compliance.

During the visit a file review was conducted for six residents files. LPA reviewed hospice and home health plans. A review of medication was completed.

An exit interview was conducted, and a copy of this report was provided to Assistant Administrator whose signature confirms receipt.

LPA to return at a later date to complete this inspection.