Facility Evaluation Report

Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted an annual required visit and inspection of the facility. LPA met with Caregiver and gained entry. The reason for this visit was explained. Caregiver contacted Administrator via phone and joined the visit.

At approximately 10:45a.m., LPA and Administrator conducted a physical plant tour. Required postings were observed in the hallway. The smoke alarms are operational and are in each bedroom, the hallway and kitchen. There are several carbon monoxide detectors that function properly. The fire extinguishers are in the kitchen and the hallways. The charge date is 03/31/2025. During this visit facility temperature was 74 degrees Fahrenheit. The facility is fire cleared for six (6) non-ambulatory residents; one (1) maybe bedridden; approve for two (2) hospice waivers. Kitchen: The kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPA found at least two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. Frozen foods are wrapped, dated, and stored properly as well. Knives were stored in a locked cabinet in the kitchen. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers. Cleaning supplies, pesticides or toxic cleaning supplies were stored and locked away in the kitchen. Staff office space is beside the kitchen. Bedrooms: There were six (6) bedrooms designated for residents' use. Bedroom #1, bedroom #2, bedroom #3, bedroom #4, bedroom #5, and bedroom #6 are all private use that has only one resident. Resident’s bedrooms were properly furnished with appropriate dresser, bedding, and linens with sufficient lighting. Bathrooms: There are three and a half (3.5) bathrooms designated for residents' use. The bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 105.9 degrees Fahrenheit for half bathroom located in the hallway beside the kitchen. Bathroom #1 in inside bedroom #6, hot water measured at 115.2 degrees Fahrenheit.