Facility Evaluation Report

Licensing Program Analyst (LPA) Abeye Duguma met with Librado De Guzman for a Required One (01) Year visit. LPA explained the reason for the visit. A tour of the physical plant was conducted at 09:30a.m. and the following was noted:

The facility is fire cleared for six (06) non-ambulatory of which one (01) may be bedridden and a hospice waiver for six (06). It has a total of four (04) bedrooms and two (02) bathrooms. The facility is currently occupying four (04) non-ambulatory residents of which three (03) are receiving hospice services.

Kitchen is sufficiently stocked with at least two (2) days perishable and seven (7) days non-perishable food. Frozen foods are wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Knives and sharps are observed to be locked and inaccessible to residents.

The living and dining room are neat and clean. The facility maintains a comfortable temperature at 72°F. The smoke and carbon monoxide detectors are hardwired, interconnected and observed to be operational. Fire extinguisher is located near the kitchen, observed to be full and last inspected on 12/10/2024.

The facility has outdoor furniture with a covered shaded area for residents and visitors. The facility does not have a swimming pool/body of water. The garage is currently being used for storage. Laundry detergents, cleaning agents and other toxins are locked away.