Facility Evaluation Report

Licensing Program Analyst (LPA) Tyler Reyes conducted an unannounced Required 1 year inspection at the facility and met with Administrator Mona Castro and explained the purpose for todays visit.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: Facility has an Infection Control Plan in place.

Operational Requirements The facility is approved for AGE RANGE 60 AND OVER. APPROVED FOR 6 NON-AMBULATORY. HOSPICE WAIVER FOR 2 RESIDENTS. A Certificate of Liability Insurance was observed and a copy was obtained.

Due to time constraints, LPA will return at a later date to complete all (12) CARE Tool domains. Exit interview conducted with Administrator Mona Shelia Castro and a copy of this report was provided.