Facility Evaluation Report

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced visit on 10/15/2025 and was greeted by the Administrator, Marita Samaniego. The Administrator, Marita Samaniego arrived to the facility at 9:45 am. LPA stated the purpose of the visit was to conduct an annual inspection. The caregivers confirmed there are four residents living in the facility. The facility is licensed for six (6) non-ambulatory residents and one bedridden resident. The facility has a hospice waiver for six residents.

LPA Spaeth and the caregiver toured the facility at 10:30 until 11:10 am.

Common Areas – The family room, dining room, and kitchen are combined. The family room was furnished with comfortable seating and a television. The dining room contained a dining room table and chairs.

Medications: LPA observed the resident medications, first aid kit, and PPE supplies were safely locked in a hallway closet.

Kitchen – LPA observed a two day supply of perishable food and a seven day supply of non-perishable food items. The fire extinguisher was located near the kitchen and was operable. The knives were locked in a kitchen drawer and the cleaning solutions were locked underneath the kitchen sink.

Laundry Room – The laundry room was locked and contained the washer/dryer, laundry detergent and additional cleaning solutions.