Facility Evaluation Report

On 06/02/26 Licensing Program Analyst (LPA) Mario Leon created an amendment of this file, which is to change this visit's type from Post Licensing to REQUIRED - 1 YEAR.

On 01/14/26 Licensing Program Analyst (LPA) Mario Leon conducted a required annual visit at the facility.

Upon entrance, LPA was met by staff one, Renette De La Cruz - Licensee (S1) and the purpose of the visit was explained.

The facility is a single-story home located in a residential neighborhood, which consists of the following: four (4) bedrooms, two “half-bath” (2) bathrooms, one (1) kitchen, (1) dining room, one (1) living room, with an attached garage, and is located within a residential neighborhood. Facility maintains all required posting throughout the facility. LPA reviewed both resident files and found that they contained all required documents. LPA reviewed two (2) staff files and found they contained the required documents, and trainings. LPA reviewed their Liability Insurance. LPA reviewed the training logs for staff . The facility has a current census of three (3) residents (R1-R3). S1 and LPA toured the facility, inside and out.

MEDICATIONS: There is a locked centralized storage area for client medications.

PHYSICAL PLANT: Facility is clean, sanitary, and in good repair. Protective devices are in place to include fire prevention and mitigation and all are operational. Indoor and outdoor passageways, inclines, ramps, open porches, and other areas of potential hazard are free of obstructions. There is one (1) pool, located in the back yard with a locked 5ft-high fence surrounding the water, making the water inaccessible to residents in care. There are locked storage areas for poisons, pool chemicals and sharps. All window screens are clean and in good repair. Facility maintains a comfortable temperature at 77.5 degrees F. The facility has central air. Inclines, ramps, open porches, and areas of potential hazard are well-lit and adequately equipped for elderly residents. Nine (9) smoke detectors are hard wired and operate properly. Two (2) Carbon monoxide detectors operate properly. S1 shut off the facility power source to indicate emergency lighting as operational.