Facility Evaluation Report

Licensing Program Analyst (LPA) Angela Panushkina conducted an unannounced annual inspection and met with the Administrator and explained the reason for the visit.

A tour of the physical plant was initiated at 11:50am and the following were observed:

Facility is approved for six (6) Non-ambulatory, of which six (6) may be Bedridden. Facility also has a hospice waiver granted for six (6) residents. The facility maintains a comfortable temperature at 73°F.

KITCHEN: The facility has a kitchen area that is equipped with a refrigerator, microwave oven and sink. LPA observed there to be sufficient stock of one-week perishable foods and two-day non-perishable foods. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. All knives and sharps are observed to be locked in a kitchen drawer and inaccessible to residents. The fire extinguisher is located by the kitchen and was last serviced on 02/19/2026.

BEDROOMS: There are six (6) bedrooms designated for resident's’ use. Bedrooms are appropriately furnished and have appropriate lighting. Facility has awake staff at night.

BATHROOMS: The facility has two (2) bathrooms. LPA observed all bathrooms have non-skid mat, soap, paper towels and hand washing signs. Extra towels and linens were readily available. The hot water temperature measured at 120°F.