Facility Evaluation Report

On 2/04/2026 at approximately 4:10 p.m., Licensing Program Analyst (LPA), Evelin Rios conducted an annual visit to the facility. LPA met with the Administrator and explained the reason for the visit. The facility has not accepted any residents.

LPA conducted a physical plant tour at approximately 4:10 p.m., and the following was observed:

The facility is a single unit building with (4) bedrooms and two (2) bathrooms. There is no designated staff room. A fire clearance was approved on 06/26/2024, for six (6) non-ambulatory residents for a total capacity of six (6).

Common areas: The living room and dining room were observed to be properly furnished and in good repair. LPA observed a fire extinguisher in the kitchen and living room to be fully charged with service date 02/07/2025. LPA observed required postings located throughout the common areas. A working telephone was observed accessible to residents.

Kitchen: The kitchen was observed clean and clear of clutter. LPA observed a sufficient supply of seven (7) day nonperishable foods and two (2) day perishable foods. The knives/sharps are kept locked in a kitchen drawer.

Bedrooms: The residents' bedrooms are adequately furnished with appropriate furniture and storage space. The passageways and hallways were observed free of obstructions. LPA observed extra linens in a hallway cabinet leading towards the bedrooms.