Facility Evaluation Report

Licensing Program Analyst (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPA met with the administrator, Gina Agustin and advised her of the purpose for the visit.

At approximately 12:00pm, LPA took a tour of the physical plant. The facility is a one (1) story building. There is an exterior fence/gate in the front yard that is only locked from the outside. Gate/door is single action. It unlocks and opens from inside the compound when exiting. The smoke alarms and the carbon monoxide detectors are dual and interconnected. The fire extinguisher is located in the living room It was purchased on 05/01/24.

Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility, sealed and properly stored. Knives were stored in a locked drawer. No cleaning supplies or cleaning agents observed out during the day's inspection.

Bedrooms: There are four (4) bedrooms. Three (3) are designated for client use. Bedroom #1 is private. Bedrooms #2 and #3 are shared rooms. One bedridden resident can be placed in either bedroom #1 or #2 (per STD 850). Bedroom #4 is reserved for staff. Rooms designated for resident use were furnished with beds, night stand, chairs, dresser, bedding and linen. Resident bedrooms have sufficient lighting and closet space.

Bathrooms: The facility has three (3) bathrooms. Bedroom #3 has it's own bathroom with shower. The other bathroom is located in the hallway, outside of bedroom #3. The third bathroom, is designated for staff. It is located by the kitchen. The bathrooms, designated for resident use were observed to have the proper