Facility Evaluation Report

On 4/25/2025, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required inspection. LPA arrived, introduced self, and allowed entrance by direct care staff. Administrator Jean Asignacion contacted by telephone and arrived a short time later to conduct facility inspection.

Upon arrival, LPA heard the sound of locks being undone prior to door being open. At entrance, LPA observed a chain lock and a barrel bolt latch on the interior of front door. When LPA inquired, Staff 1 (S1) stated they were used to keep Resident 1 (R1) from exiting facility.

Currently, there are 3 residents residing in facility, there is 1 shared room, and 1 private room. LPA conducted facility tour with Administrator. Facility toured resident bedrooms and observed bedrooms to have required furnishings. Resident bathroom toured, LPA observed fixtures operational, there are grab bars, and skid resistant mats in the shower for residents. Water temperature measured at 111 degrees F. All common areas have adequate seating available for residents. Kitchen toured, LPA observed adequate food supply for the residents in care. LPA observed knives to be stored under kitchen sink, LPA observed knives to be stored under kitchen sink, cabinet door was unlocked and lock was observed to not be working properly.

Fire extinguisher present with a purchase date of 4/01/25. Smoke detectors and carbon monoxide detectors observed operational during inspection.

Outside of facility toured. Designated fire exit free of obstruction, and gate observed to not be self-latching.