Facility Evaluation Report

On 06/30/2026, at approximately 11:00 AM, Licensing Program Analyst (LPA) Jose Anguiano conducted an unannounced annual required visit. LPA met with Licensee Tracy Moore.

The facility is licensed to serve six (6) residents aged 60 and above, all of whom may be non-ambulatory. The facility has a hospice waiver approved for a maximum of six (6) hospice residents. There are currently five (5) residents in care.

The facility is a single-family home located in a residential area and consists of a kitchen, dining room, office area, living room, three (3) bedrooms, two (2) bathrooms, garage, storage area for supplies, and a backyard with shade. LPA conducted a tour of the physical plant. No obstructions were observed on the premises. A covered jacuzzi was observed in the backyard.

LPA inspected three (3) bedrooms and two (2) bathrooms. Beds and bedding supplies were observed to be in good condition. Adequate lighting was provided, and storage space for residents’ personal belongings was observed. Bathrooms were clean and equipped with grab bars and non-slip mats. Smoke detectors and carbon monoxide detectors were tested and found to be operable and in good condition. The water temperature was tested at 116 degrees Fahrenheit.

During the visit, the facility was observed to be clean, sanitary, and appropriately furnished. Personal hygiene items were stored appropriately. Cleaning supplies, toxins, and sharp objects were stored in a manner that made them inaccessible to residents in care. The kitchen was inspected, and sufficient perishable and non-perishable food supplies were observed and adequately maintained.

Please see report continuation on (LIC809-C)