Facility Evaluation Report

Licensing Program Analyst (LPA) Abeye Duguma met with the administrator, Cherry Monje-du, and explained the reason for the visit. Due to unforeseen circumstances, Cherry could not complete the tour and designated Elizabeth Mercado to sign and accept the report. A tour of the physical plant was conducted at 11:45 AM and the following was noted:

The facility has outdoor furniture with a covered shaded area for residents and visitors. The garage is currently being used for laundry and storage. The facility does not have a swimming pool/body of water.

The facility has a total of four (04) bedrooms and two (02) bathrooms. The facility is fire cleared for six (06) non-ambulatory of which one (01) may be bedridden and a hospice waiver for two (02). The facility is currently occupying five (05) non-ambulatory residents.

The living and dining room are neat and clean. The residents' rooms are adequately furnished with appropriate lighting system. Hallways are well lit. Residents have enough personal hygiene product provided by the licensee. (CONT on LIC 809-C)