Facility Evaluation Report

Licensing Program Analyst (LPA) Mariana Agban conducted an Annual Required visit and inspection of the facility. LPA arrived granted access by Staff#1. LPA met with Administrator Catherine Santos shortly after and explained the reason for the visit. At approximately 10:05 am, with the assistance of S1, LPA took a tour of the physical plant and the following were observed. Required postings were observed in the entry area.

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 cabinet. The fire extinguisher is located in the kitchen. The charge date is August 15, 2025. The smoke alarms and carbon monoxide detectors were tested and were function properly.

Bedrooms: There were five (5) bedrooms designated for residents' use. All five bedrooms, in use by residents, were properly furnished with appropriate beddings and linens with sufficient lighting.

Bathrooms: There are two (2) bathrooms designated for residents' use. Both bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured from the bathroom sink at 106.5 and 108.9 degrees Fahrenheit. No cleaning supplies or hazardous items were present in each bathroom during the inspection.

Common Areas : These included the living room and dining area. The common areas were properly furnished. Furniture was observed to be in good condition and adequate seating for residents. The auditory alarms on all exit doors were on and functional at the time of the visit. There is a fireplace that is properly screened. The fireplace is non-functional. No key to the fireplace, and fireplace tools were not present (Continue on 809C)