Facility Evaluation Report

Licensing Program Analyst (LPA) Abeye Duguma met with Remigia Bergonio for a Required One (01) Year visit. LPA explained the reason for the visit. A tour of the physical plant was conducted at around 12:45 PM and the following was noted:

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.

The facility is fire cleared for six (06) non-ambulatory and a hospice waiver for two (02). The facility is currently occupying four (04) residents.

The facility has a total of three (03) bedrooms for residents and two (02) bathrooms. The living and dining room are neat and clean. The residents' rooms are furnished with appropriate lighting system. Hallways are well lit.

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. Knives and sharps are observed to be locked and inaccessible to residents.