Facility Evaluation Report

On 01/31/2026 at 10:00 am Licensing Program Analyst (LPA) Lorena Casillas met with Administrator Stephen Racine for an unannounced one (1) year Required visit for this facility. LPA was greeted and granted access by Administrator, LPA informed the Administrator of the purpose of the visit, and an entrance interview was conducted.

Infection Control and Emergency Preparedness Plans: LPA reviewed the facility mitigation plan (approved on 04/ 1 5/21) to make sure the licensee was following current infection control recommendations. LPA also reviewed facility emergency preparedness plan and quarterly emergency drills.

A tour of the physical plant was conducted with the Administrator at 11:00 am. The facility has six (6) bedrooms and two (2) bathrooms currently occupying three (3) residents. One (1) bedroom is designated for staff use only. The facility is Fire Cleared for six (6) ambulatory of which five (5) can be non-ambulatory, and a hospice waiver for four (4). Currently the facility has no residents in hospice. All three (3) residents were present and in their rooms.

Kitchen: At approximately 11:00 am LPA conducted a tour of the kitchen and observed there to be sufficient stock of two-day perishable and seven-day non-perishable foods. Frozen foods are properly wrapped and stored. Food storage and preparation areas are clean and inaccessible to pests. LPA observed all knives and sharp objects locked and inaccessible to residents in care. There is a pantry located in the hallway that has a fridge for additional food storage.