Facility Evaluation Report

On 5/28/2025, Licensing Program Analyst (LPA) M. Medina arrived to conduct an unannounced Annual Required inspection. LPA arrived, stated purpose of visit and allowed entrance by DSP. Patrick Nankil, notified by telephone and arrived a short time later to conclude facility inspection.

Currently, there are 2 residents in placement. Both residents were present during today's inspection. Facility observed to be a 5 bedroom, 3 bathroom home, all bedrooms are private.

Facility observed to be well lit, clean, and odor free. LPA observed walls in entry way in need of painting. LPA observed, dining room, living room and family room to have adequate seating and lighting for residents. Resident bedrooms observed to have all required furnishings. Resident bathrooms toured, all fixtures observed to be operational. Water temperature measured at 110 degrees F. Kitchen toured, LPA observed a 2-day supply of perishable and a 7-day of non-perishable food available. All knives observed to be locked and secured in kitchen drawer. Medications observed to be locked and secured in filing cabinet. Medications observed to have original labels and to be administered as prescribed.

Fire extinguisher present with a purchase date of 10/08/2024. Last fire drill conducted 3/10/2025 according to facility records All chemicals utilized for cleaning are locked and secured in cabinet in garage.

Outside of facility toured. LPA observed all exits to open free of obstruction. LPA observed back patio in need of cleaning, patio table in need of repair and/or replacement. LPA observed back yard in need of cleaning.

No deficiencies observed during today's inspection.