Facility Evaluation Report

On 01/05/2026 at 9:30 a.m., Licensing Program Analyst (LPA) Evelin Rios conducted an unannounced Required Annual Inspection at this facility. LPA was greeted by caregiver who granted access. LPA explained the reason for the visit. Caregiver sent the administrator, Sunday Olowosagba a message and informed him LPA was at the facility to conduct an annual visit.

A physical plant tour was initiated at approximately 10:00 a.m., and the following was observed:

Entrance: LPA observed required postings at the facility's entrance and a sign in sheet for visitors. LPA observed a fully charged fire extinguisher with service date 05/29/2025.

Common Areas: These include the two (2) dining areas, living area and a sitting/office area. All common areas were observed clean. There is a television and board games available to residents in the living room. Facility files are kept locked in filing cabinets in the dining area.

Kitchen: LPA observed the kitchen to be clean and clear of clutter. LPA observed a fire extinguisher with a service date of 05/29/2025, fully charged. LPA observed, centralized medications locked in a kitchen cabinet. LPA observed a small refrigerator for medication that requires refrigeration locked. LPA observed a 2 day perishable and 7 day non perishable supply of food in the facility.

Surrounding Grounds : There is appropriate outdoor seating for residents. Auditory alarms on exit doors were observed on and functioning.

Laundry Room/Garage: LPA observed a washer, dryer detergents and cleaning products locked in the laundry room. Through the laundry room is the door to the garage. Garage is used for facility storage. LPA observed a second refrigerator. (Continued to LIC809-C)