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 Ana Aparicio and explained the reason for the visit. Maxson Raharuhi, Assistant Administrator arrived shortly thereafter.

The facility is licensed to serve residents ages sixty (60) and older. The approved capacity is six (6) non-ambulatory residents. The facility is approved to retain no more than two (2) residents receiving hospice care.

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. Oxygen was observed in use in the facility. Required “Oxygen in Use / No Smoking” signs were posted throughout the facility in visible locations. Residents had access to personal space, privacy, and adequate storage. No firearms/weapons were present.

The facility is in a residential area and is a one-story home consisting of four (4) resident bedrooms, one (2) restroom one being a guest restroom, living room, kitchen, laundry room, dining area, laundry room, garage, front yard, and backyard. Property includes a caregiver corridor near bedroom four (4). LPA observed four (4) resident bedrooms, and all contained the required furniture (bed, mattress, linens, dresser, chair, and lighting). Cleaning supplies and toxic substances were accessible to residents in a kitchen cabinet under sink.