Facility Evaluation Report

Licensing Program Analyst (LPA) Abeye Duguma met with administrator, Ruskie Ragasa, for a Required One (01) Year visit. LPA explained the reason for the visit. A tour of the physical plant was conducted at around 09:30a.m. and the following was noted:

There is one entrance being utilized at the facility. The facility is fire cleared for six (06) non-ambulatory of which one (01) maybe bedridden and has a hospice waiver for six (06). The facility has a total of five (05) bedrooms, of which four (04) are for residents and one (01) is for staff. The facility has two (02) bathrooms for both residents and staff.

The facility has outdoor furniture with a covered shaded area for residents and visitors. The facility has a swimming pool with required lock fencing. The garage is currently being used for storage and laundry. Laundry detergents, cleaning agents and other toxins are locked away.

Kitchen is sufficiently stocked with at least two (02) days perishable and seven (07) days non-perishable food. Frozen foods are wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Knives and sharps are observed to be locked and inaccessible to residents.

The living and dining room are neat and clean. The facility maintains a comfortable temperature at 76°F. The smoke and carbon monoxide detectors are hardwired, interconnected and observed to be operational. Fire extinguisher is located in the kitchen, observed to be full and last inspected on 07/02/2025. (continued on LIC 809-C)