Facility Evaluation Report

At 12:00pm, Licensing Program Analyst (LPA), Angela Panushkina conducted an unannounced annual inspection at the facility mentioned above. LPA met with the Administrator and explained the reason for the visit.

Facility is licensed for capacity of six (6) Non-Ambulatory residents. LPA observed six (6) bedrooms, two (2) single and two (2) double occupancy for residents’ use. Two (2) staff rooms are located upstairs. All bedrooms have sufficient lighting, properly furnished, clean and have appropriate bedding and linens. Auditory alarms were tested and observed to be operational. Facility has three (3) full bathrooms. The staff bathroom is located upstairs, and both resident bathrooms are located downstairs. All bathrooms were observed to be clean and in good repair. Properly supplied with toilet paper, soap and paper towels. The hot water temperature measured at 106.4°F. LPA observed appropriate grab bar and non-skid mat. All trash cans in bathrooms had fitted lids to protect them from cross contamination.

The facility maintains a comfortable temperature at 72°F. The Common areas are furnished with adequate furniture to accommodate a maximum capacity of six (6) residents.

At approximately 12:15pm, LPA toured the kitchen area and observed enough supplies of staple non-perishable for minimum 1 week and perishable for 2 days at the facility. All knives and sharps are observed to be locked in a kitchen drawer and inaccessible to residents. There is a fire extinguisher in the kitchen, and it was last serviced on 03/20/2025.