Facility Evaluation Report

At 10:00 a.m., Licensing Program Analyst (LPA) Evelin Rios arrived at the facility listed above to conduct an unannounced annual inspection. LPA was greeted by a staff #1(S1) and granted access. LPA signed in and checked temperature. LPA informed staff #2(S2) the reason for the visit and to inform the administrator LPA was at the facility. S2 called the owner Anne Gregorio and informed her LPA was at the facility. S2 informed LPA the owner would meet with LPA shortly. There are two (2) residents present. LPA observed resident #1 (R1) in the living room with a visitor and resident #2(R2) was in their private bedroom.

At 10:16 a.m., LPA toured the physical plant of the facility inside and out and the following was observed.

Common Areas : LPA observed appropriate postings at the entry of the facility. The facility maintains a comfortable temperature of 76°F. The living room and dining area were clean, clear of clutter and were properly furnished. Dining area had a table and chairs that sit the capacity of the facility. Living area had a television and seating for the capacity of the facility. LPA tested two (2) of two (2) carbon monoxide detectors and they were observed functioning properly at 10:23 a.m. Kitchen: The kitchen was observed to be clean and clear of clutter. Appliances and fixtures were functioning properly. LPA observed knives locked in a kitchen drawer. LPA observed a sufficient amount of 2-day perishable and 7-day non-perishable food. On a wall leading to the kitchen LPA observed one (1) fire extinguisher fully charged with a last serviced date of 05/02/2024. Bedrooms: LPA inspected five (5) out of five (5) resident bedrooms. One (1) out of the five (5) bedrooms is a shared bedroom. LPA observed each resident room to be properly furnished with one bed, a night stand, one chair, bedding, sufficient lighting and storage. LPA opened exterior doors in all resident bedrooms and observed the auditory alarms were functional. (Continued on LIC809-C)