Facility Evaluation Report

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced visit on 12/23/2024 and was greeted three caregiver at 10:00 am. LPA stated the purpose of the visit was to conduct an annual inspection. The caregiver confirmed there are five residents. The facility is licensed for a total of six non-ambulatory residents of which two can be bedridden. The Administrator, Stephanie Domingo arrived at 11:00 am.

LPA Spaeth and the Administrator toured the location at 10:00 am until 10:40 am.

Common Areas – LPA observed the family room, kitchen, and dining room are combined. The family room contained comfortable seating and a television. The dining room section contained a dining room table and chairs.

Kitchen – LPA observed a two-day supply of perishable food and a seven-day supply of non-perishable food items. The medications are locked in a kitchen cabinet. The knives were locked in a kitchen drawer. A fire extinguisher was located in the kitchen area. LPA observed a resident's medication is stored in the refrigerator but is not locked in a safe location.

Staff Room - LPA observed the staff was not locked but there were no safety hazards located in the room.

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

Hallway – Clean linens are stored in cabinets.