Facility Evaluation Report

On _01/10/25__, Licensing Program Analyst (LPA) Yolanda Rosser__ conducted an announced required inspection. LPA met with Licensee/ Administrator, _Ana Ramos_. LPA explained the purpose of today’s visit. The facility is licensed for Six (6) non-ambulatory clients of which one (1) bedridden (1) one Hospice Resident. 60 yrs. old and above. Census is zero (0).

Administrator, Ramos is closing facility due to last client passing away as of October 21,2024.

Structure The facility is a single-story structure located in a residential neighborhood. It consists of the following: Five (5) client's rooms, Four(4) bathrooms, living room, dining area, kitchen, and an office area and den areas.

Bedrooms: Bedroom C was inspected, there were a few bags(3) that were due to be picked up by the Trustee or donated if need be. (Very few personal effects, clothes, shoes, socks)which will be disposed of as soon as the trustee picks them up. All other items items were previously picked up by the Trustee.

All medication was destroyed and all records will be maintained for 3 years per protocol.

An exit interview was conducted and a copy of this report was left with Administrator.