Facility Evaluation Report

At 10:15 a.m., Licensing Program Analyst (LPA) Evelin Rios arrived at the facility to conduct an unannounced annual inspection. Upon arrival, LPA was greeted by the Administrator, Flor Lobo. LPA explained the purpose of the visit. LPA observed required postings in the entry area and accessible hand sanitizer, gloves, and masks for visitors. LPA was asked to sign in the visitors log and take their temperature. This is a Residential Care Facility for the Elderly (RCFE) . A fire clearance was approved on 01/03/2025 for two (2) ambulatory and four (04) non ambulatory residents.

At 10:20 a.m., LPA initiated a physical plant tour of the inside and outside of the facility. The following observations were made:

At 10:22 a.m., LPA observed the administrator test the hard wired, interconnected, dual smoke and carbon monoxide detectors. Smoke and carbon monoxide detectors were observed to be functioning properly.

Kitchen: The kitchen appliances and fixtures appeared functional. LPA found a sufficient amount of 2-day perishable and 7-day non-perishable food at the facility. LPA observed some repackaged food that was properly stored in clearly labeled, containers. LPA observed knives and sharps locked in a kitchen drawer inaccessible to residents. The fire extinguisher is located in the kitchen and was observed fully charged with service date 06/02/2025.

Common Areas : These included the living area and dining area. The common areas were properly furnished. The couches and the dining table sits the capacity of the facility and were observed in good repair. A fireplace in the living area was properly screened. LPA observed a facility telephone accessible to residents. Overall the facility was clean and clear of clutter. (Continue on LIC809-C)