Facility Evaluation Report

Licensing Program Analyst (LPA) Lorena Casillas met with administrator Aldrin Perez for an unannounced one (1) year Required visit for this facility.

LPA arrived at 12:10 pm and was greeted by a caregiver. Caregiver called Administrator and LPA informed the Administrator of the purpose of the visit. Administrator arrived at 1:10 pm.

At 12:35 p.m. LPA began a physical plant tour of the facility, and the following was observed:

There are five (5) residents in the facility. Three (3) residents are bedridden, one (1) of which is in hospice care. Two (2) residents are non-ambulatory. LPA observed all residents to be in their rooms watching TV.

Kitchen: LPA observed the kitchen to be clean and clear of clutter. All appliances were operative. Knives are kept locked in a kitchen cabinet inaccessible to residents. LPA observed smoke alarms throughout the facility that are interconnected. At 1:55 p.m. all smoke alarms were tested and functioned properly. LPA observed one carbon monoxide detector and it appeared to be functioning. There is a fire extinguisher located in the kitchen last purchased on 05/24/2023.

Dining / Living Area: The dining and living area were well lit, clean, and clear of clutter. Furniture appeared clean and in good repair. A fireplace located in the living area is not in use and is blocked off making it inaccessible to residents. LPA observed the thermostat at a comfortable temperature of 76°F. There was a fire extinguisher observed by the entrance and was last purchased on 5/24/2023.

Bedrooms: There are five (5) bedrooms designated for resident use. One (1) out of the five (5) rooms is shared. All resident rooms are furnished with required lighting, dresser, chair, bed, and linens.