Facility Evaluation Report

Licensing Program Analyst (LPA) Vaid conducted an unannounced licensing inspection visit. Caregiver Noberto Teguinos allowed entry to the facility. Barbara Boiston, house manager arrived shortly after and the purpose of the visit was discussed. Facility is licensed to serve six (6) non-ambulatory elderly residents, ages 60 and above. Hospice waiver approved for six (6) residents. No bedridden allowed. Five residents currently residing in the facility. Two residents are on Hospice.

During the visit, CARE tool was used, a tour of the facility was conducted, food supply/medication were reviewed, staff/residents were interviewed, and staff/residents’ records were reviewed. Administrator certificate expires 11/19/2025, house manager certificate expires 9/6/26.

The facility is located in a residential neighborhood. The facility consisted of four (4) bedrooms, two (2) bedrooms are shared, and two (2) bedrooms are private, two (2) bathrooms, kitchen, dining room, laundry room, garage, and living room with a TV. All the rooms were furnished with appropriate furniture for residents’ comfort. The bathrooms were furnished with grab bars and nonskid surfaces. Common areas were observed for the ability to safely serve the needs of the residents. Hot water temperature was measured in the kitchen, bath 1 and bath 2, between 105-120 degrees Fahrenheit. Adequate linen and personal hygiene supplies were observed. No pools and bodies of water on the premises. Facility maintained a comfortable temperature for residents. Auditory alarm devices to monitor exits were operable. Sufficient supplies of 2-day perishable and 7-days nonperishable foods were observed. Knives, tools, sharp items were inaccessible to residents. Smoke detectors and carbon monoxide detectors are interconnected and were operable. Medication, residents’/ staff’s records were centrally stored in a locked cabinet and inaccessible to residents. Toxic substances were inaccessible to residents. Liability insurance expires 06/27/2027. Safety drill was conducted 07/06/2026. First aid and CPR certificates are valid

No deficiencies were observed during this visit. An exit interview was conducted and copy of this report was provided to house manager Barbara Boiston.