Facility Evaluation Report

On 12/12/2024 at approximately 09:40 AM, Licensing Program Analyst (LPA), Angelica Segovia conducted an unannounced annual visit to the facility. Upon arrival LPA was greeted by Caregiver Myriam Reina. LPA stated the reason for the visit. The Administrator James Durando along with House-Manager Nancy Magallanes arrived shortly after to assist with today's visit.

LPA asked for census, staff, and resident files…. LPA conducted a physical plant tour at approximately 11:00 AM and the following was noted:

There is only one entrance being utilized at the facility. The facility is a single unit building with five (5) bedrooms and two (2) bathrooms currently occupying four (4) residents. One (1) room is designated for staff use only.

Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available. Required postings such as Emergency Disaster Plan, See/Say Something, Long-Term Ombudsman were located alongside reception desk within the living room.

Common areas observed to be neat, clean, and organized. Common areas observed to be properly furnished and in good repair. The facility maintains a comfortable temperature at 70°F. Fire extinguisher located near the kitchen and dated 05/30/24.

The kitchen observed to be fully stocked with two (2) days perishable and seven (7) days non-perishable food. Kitchen observed to be clean and inaccessible to pests. Knives and sharps observed to be locked alongside medication in a kitchen cabinet inaccessible to residents. Stove observed to be working and in proper condition. Small dining table located in the kitchen observed to be neat, clean, and properly furnished. (continued on LIC 809-C)