Facility Evaluation Report

At 11:45a.m., Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted an unannounced Required One (1) year inspection to the facility. LPA met with the staff who granted entry to the facility and explained the reason for the visit. At about 11:55a.m., Administrator joined today’s visit.

At approximately 12:30p.m., LPA and Administrator conducted a physical plant tour inside and out. During the tour, LPA observed that the facility is a single-story home located in a residential community with six (6) bedrooms and three (3) bathrooms. Fire Clearance was approved on 12/15/2017 (6) non-ambulatory and (6) bedridden residents. Approved hospice for two (2). Fire Emergency drill was last conducted on 03/01/2026. The facility is currently occupying five (5) residents. Facility maintains a telephone land line and it was observed to be operational. Required postings were observed in the dining area. The dual fire sprinkler/smoke detector appeared to function properly located in each bedroom and dining area. The carbon monoxide detector is located in the dining room. The fire extinguishers are throughout the facility with service date of 01/21/2026. During the visit the facility is set at 73 degrees Fahrenheit.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Kitchen: LPA observed kitchen appliances and fixtures were functional. The kitchen has a working stove, freezer, refrigerator, microwave and dish washer. LPA found at least two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. Frozen foods are wrapped and stored properly as well. Knives were stored in a locked drawer in the kitchen. Food storage and preparation areas are clean