Facility Evaluation Report

Licensing Program Analyst (LPA) Gabriela Castro conducted an unannounced required annual visit using the Compliance and Regulatory Enforcement (CARE) Tool. LPA was greeted by Katherine Pavon, Administrator explained the reason for the visit.

This home is licensed to serve 6 residents ages range 60 and over, six (6) non-ambulatory of which one (1) may be bedridden. Facility has a hospice waiver for six (6) residents.

There were two (2) residents under hospice care during inspection.

Personal Rights postings (LIC 613C and Ombudsman), Complaint Poster (PUB 475), and nondiscrimination notice were observed in a common area. Residents had access to personal space, privacy, and adequate storage. No firearms/weapons were present. “No smoking - Oxygen in Use signs” in various locations of the facility.

The facility is in a residential area and is a one-story home consisting of four (4) resident bedrooms, two (2) bathrooms, living room, kitchen, dining area, attached garage, front yard, and backyard. Each resident bedroom contained the required furniture (bed, mattress, linens, dresser, chair, and lighting). Cleaning supplies and toxic substances are inaccessible to residents locked in garage cabinets.