Facility Evaluation Report

Licensing Program Analyst (LPA) Galarza conducted an unannounced Required- 1 year visit. The purpose of the visit was explained to Administrator Ana Santos. Assistant Administrator Mauricio Santos Jr arrived shortly after. There are currently 4 elderly residents 60 years and older residing in the facility. The following 12 Care Compliance and Regulatory Enforcement (CARE) tool domains were utilized during the inspection.

The facility has an Infection Control Plan. A visitor sign-in sheet is in place.

An Infection Control Plan has been added to the Plan of Operation.

The facility has a Dementia Waiver in place and an approved Hospice Waiver for 4 residents.

A fire clearance for 6 non-ambulatory adults 60 and over; of which three (3) may be bedridden in rooms 2, 3, and 4 only.

Liability Insurance in the amount of at least ($1,000,000) per occurrence and ($3,000,000) in total annual aggregate is in place and expires 10/6/2023.

A surety bond is not applicable. Facility does not handle resident's money.

Liability Insurance in the amount of ($1,000,000) per occurrence and ($3,000,000) in total annual aggregate is current with an expiration date of 10/6/2024.

Facility has an American Red Cross 1st Aid kit and manual.

No Surety bond is in place. Facility does not handle resident monies.