Facility Evaluation Report

On 03/5/2026 at 02:15 PM, Licensing Program Analyst (LPA) Bernadette Allen conducted an unannounced visit to conduct an annual inspection. LPA introduced herself to Flor Famisan- Caregiver who allowed LPA entry into the facility.

The facility is licensed to serve 6 non-ambulatory clients ages 60 and over. One (1) may be bedridden in room 2 only. The facility has a hospice waiver approved for 3. The facility has four (4) clients and two (2) clients are receiving hospice care.

The facility is a single-story home in a residential area which consists of four (4) bedrooms, two (2) bathrooms, living room, dining room, kitchen, washer and dryer/ storage area, backyard with table and chairs.

At 3:00 PM, LPA reviewed three (3) staff files for First Aid/CPR certification, criminal record clearance, training, and health screenings which were current. LPA also reviewed four (4) clients’ files for admission agreements, updated physician reports, needs and services plans all of which were current.

At 3:45 PM, LPA and Rosemarie toured the physical plant inside and outside of the facility and there were no obstructions or bodies of water on the premises.

LPA inspected a total of four (4) bedrooms and two (2) bathrooms. LPA observed the bedrooms to have the required furniture which appeared to be in good repair. The rooms also have adequate lighting, and storage for the clients’ personal belongings. The bathrooms also were observed to be operational with handrails and shipmates.