Facility Evaluation Report

Licensing Program Analyst (LPA) Elena Mallett conducted an unannounced Annual Continuation visit to complete the CARE tool domains that were not completed during the original visit. The original visit was conducted on 12/29/25. LPA Mallett was met by Administrator Hiransha Keerthisinghe and the purpose of the visit was explained. The facility is licensed to serve 6 Non-Ambulatory Residents, one of which may be bedridden, ages 60 and above, with a hospice waiver for (4) four. Currently none of the residents are bedridden. One resident is on hospice.

LPA utilized Compliance and Regulatory Enforcement (CARE) tools for the visit today and for the initial visit. LPA observed the following during today’s visit:

Infection Control: Staff are cleaning and disinfecting throughout the day. Facility has sufficient PPE supplies and has an Infection Control Plan maintained at the facility.

Operational Requirements: The facility has an approved fire clearance, there is a plan of operation with required Infection Control Plan and facility maintains current, required liability insurance.

Staffing : There appears to be sufficient staffing at all times in the facility. With night staff that is trained and able to assist in care and supervision of the residents in the case of an emergency.