Facility Evaluation Report

On 08/07/24, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced required – annual inspection and met with Caregiver Mignon Diaz . The Administrator Virginia Asis arrived later.

The facility is licensed to serve residents aged 60 and over, six non-ambulatory. They have an approved Hospice Waiver for six residents. Annual Fees are current. The facility is a single-story structure located in a residential neighborhood. It consists of the following: three (3) bedrooms, 2 bathrooms, living room, kitchen, dining room, family room, garage, and a shaded area.

The Caregiver and Administrator accompanied LPA inside and outside the facility during this inspection.

Two (2) resident records were reviewed and, 2 out of 2 resident records had medical assessments. Two residents’ medication was reviewed.

Deficiencies were observed. Due to insufficient time, an annual continuation is required.

An exit interview was conducted and a copy of this report was discussed with Administrator Virginia Asis and left with Caregiver Mignon Diaz.