Facility Evaluation Report

On 06/05/25, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced required – annual inspection and met with Co-Administrator Rodolfo "Nino" Lozada.

The facility is licensed to serve six (6) non-ambulatory residents, of which one may be bedridden. The facility has a hospice waiver approved for six residents. Bedrooms #1, #2, and #4 are approved for non-ambulatory or bedridden residents. The facility consists of five (5) resident bedrooms, two and one half (2 ½ ) bathrooms, kitchen with office space, family room/activity area, dining room, staff bedroom adjacent to the family room, and shaded patio. Annual fees are current.

During the inspection, LPA toured the facility, reviewed facility and residents’ records, and resident medications. Deficiency was observed (see LIC809D) during today’s visit. Due to insufficient time, an annual continuation is required.

An exit interview was conducted and a copy of this report was discussed and left with the Co-Administrator Rodolfo "Nino" Lozada.