Facility Evaluation Report

On 01/30/2025, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced required – annual inspection and met with Staff . The Area Manager Irene Formentera arrived later.

The facility is licensed to serve twelve (12) non-ambulatory residents age 60 and above. Four residents may be bedridden and rooms 1, 2, & 9 are cleared for bedridden. The facility has a hospice waiver for seven residents. Annual Fees are current. The facility is a single-story family home located in a residential neighborhood. It consists of an attached garage (includes laundry area), front office, eight resident bedrooms (#1 - #8) and one staff bedroom, five bathrooms, dining area, and living room. A shaded area furnished with outdoor patio furniture, including tables and chairs, surrounds the perimeter.

Staff accompanied LPA inside and outside the facility during this inspection. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. Common areas inside the facility were clean and clear of hazards.

Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. There are no security bars or weapons on the premises. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, and hot water temperature properly measured between 116 F. Continue to LIC809-C.