Facility Evaluation Report

Licensing Program Analyst (LPA) Abeye Duguma met with Marvin Diones for a Required One (01) Year visit. LPA explained the reason for the visit. The administrator, Daniel Cho, designated Marvin Diones to sign and accept this report. A tour of the physical plant was conducted at around 10:30 AM and the following was noted:

The facility has garage with parking space in the front. Garage is currently being used for storage. There is outdoor furniture with a covered shaded area available for residents and visitors. LPA did not observe a swimming pool/body of water.

The facility is fire cleared for six (06) non-ambulatory and a hospice waiver for two (02). The facility is currently occupying two (02) residents.

The living and dining room are neat and clean. The facility has a total of four (04) bedrooms and two (02) bathrooms. Hallways are well lit. The residents' rooms are adequately furnished with appropriate lighting system. The bathroom was checked for cleanliness and proper operations.

Kitchen is sufficiently stocked with at least two (02) days perishable and seven (07) days non-perishable food. Frozen foods are wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests.