Facility Evaluation Report

On 10/08/2025 at 11:00am, Licensing Program Analyst (LPA) Zina Brown conducted an unannounced visit to the above facility. The purpose of today’s visit was to conduct the one (1) year annual inspection. LPA met with Ivonne Meader (Administrator) and Elsa Roman (Assistant Administrator) the purpose of the visit was discussed. Facility is licensed to serve 6 non-ambulatory residents and an approved for six (6) hospice waivers. The six (6) of the residents are diagnosed with dementia, one (1) hospice, zero (0) home health resident and zero (0) bedridden resident.

The facility has a current administrator certificate (#7033600740) for Ivonne Meader valid from 08/20/2024 -08/19/2026 .The facility fees are a at $0 (paid on 10/06/2025 ; confirmation # 983254).The facility has liability insurance with Sunland Risk Retention Group with each occurrence at $1,000,000 and general aggregate at $3,000,000 (policy #SRRG2025-191) effective date 08/15/2025 - 08/15/2026. The disaster drill was conducted on 10/03/2025 (for power outage).

The facility is a two (2) story home consisting of: (6) resident bedrooms, (2) full bathroom, (2) resident toilet rooms, (1) living/entry room, (1) dining room/tv/activity room, (1) kitchen, (1) detached garage with extra refrigerator, (1) laundry room, and (2) hallway closets. The second floor consist of (1) staff bedroom, (2) staff bathrooms and (1) office room. The outside of the facility provides an (3) outdoor shaded area with a front and backyard.