Facility Evaluation Report

On 06/06/2025, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced Annual Visit using the CARE Inspection Tool. LPA met with Administrator, Ana Tojo, and the purpose of today’s visit was explained. LPA was granted entry into the facility. The facility is licensed to served six (6) non- ambulatory residents, of which two (2) may be bedridden. The facility has an approved hospice waiver for two (2) residents.

Physical Plant/Structure The facility is a single-story structure in a residential neighborhood. It consists of the following: four (4) resident rooms, two (2) bathrooms, living area, dining area, kitchen, attached garage, and outside patio area. On the patio, LPA observed two (2) tables with umbrellas and chairs. LPA observed all walkways around the facility to be clean, clear, and free of obstructions, debris, or hazards. LPA did not observe any bodies of water on the premises.

Bedrooms LPA inspected all resident rooms and observed the walls and floors to be in good repair. LPA observed all resident rooms had the required furniture including a bed, dresser, nightstand, and storage space for personal belonging.