Facility Evaluation Report

On 08/21/25, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced required – annual inspection and met with Administrator JM Demafelix. The Area Manager Irene Formentera arrived later. On 08/29/25, LPA conducted an unannounced annual continuation.

The facility is licensed to serve six (6) residents aged 60 and over. Six (6) bedridden residents are approved in Rooms A, B, C, D, E, and F. There is currently one bedridden resident. The facility has an approved hospice waiver for six (6). Annual Fees are current. The facility is a single-story house located in a residential neighborhood and consists of six (6) bedrooms, three (3) bathrooms, kitchen, activity room, living room, dining room, and an attached garage. The facility is clean, sanitary, and in good repair.

The House Manager 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 were clean, clear of hazards, and doorways were free of obstruction. Continue to LIC809-C.