Facility Evaluation Report

Licensing Program Analyst (LPA) Elizabeth Irra conducted an annual inspection visit. LPA met with Joanne Sta Clara and discussed the purpose of today’s visit. Barbara Mitchell Boiston (Manager) arrived at approximately 11:30 A.M..

This home is a single-story home with a fire clearance for (6) non-ambulatory residents. This home also has an approved Dementia Care Plan and a Hospice Waiver approved for (6) residents. There is currently (2) resident receiving hospice care. There are (2) residents receiving Home Health Agency services. A copy of liability insurance coverage was obtained for review.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: Facility has an Infection Control Policy in place.

Operational Requirements: Facility is adhering to the operational requirements.

Physical Plant & Environment Safety: LPA toured facility grounds. Fire smoke alarms and carbon monoxide detector observed. The fire extinguisher observed and appeared to be full (located near the kitchen area- last serviced on 04/16/25). Last drill was conducted on 01/09/25. Bedrooms have the required furniture. Supply of food (perishable and non-perishable) was observed. Bathrooms have non-skid surfaces and grab bars. Hot water temperature measured between 114.4* to 115.1*.

**Refer to LIC 809C for the continuation of this report**