Facility Evaluation Report

Licensing Program Analyst (LPA) Evelin Rios conducted an unannounced Annual Required visit for this facility. LPA met with the administrator, Mark Belmonte and explained the reason for the visit. The facility is licensed for a total capacity of six (06) with fire clearance for five (05) non-ambulatory residents, and one (01) bedridden.

At approximately 12:00 p.m., LPA and administrator toured the physical plant of the facility inside and out and the following was observed: At entry LPA observed a sign in log for visitors and a digital thermometer affixed to the wall. LPA observed appropriate postings.

Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of two day perishable and seven day non-perishable food at the facility, properly stored. Knives and sharps were stored in a locked kitchen drawer. LPA observed cleaning supplies locked under the kitchen sink cabinet. Centrally stored medication was observed locked in a kitchen cabinet. One (01) fire extinguisher in the kitchen was observed fully charged with service date 07/12/2024.

Surrounding Grounds : Entry/exits were free of obstructions. The outdoor patio offers shade and there was furniture appropriate for outdoor use. The outdoor area was free of hazards and fenced in. No bodies of water observed.

There are dual carbon monoxide and smoke detectors that are hard wired and interconnected though out the facility. Administrator tested detectors at 12:25 p.m., and LPA observed detectors functioning properly. Fire door closed when test was conducted. (Continue to LIC809)