Facility Evaluation Report

Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced Required- 1 year visit. LPA was met by Joel Basillo and Cathlyn Eroza, Caregivers and explained the purpose of the visit. The administrator, Terry McGenn was called to inform of the visit. At 10:25am, Barbara Boiston, House Manager arrived and assisted LPA. The facility is approved to serve residents age range 60 and above. Facility fire cleared for (2) ambulatory and (4) non ambulatory residents age 60 and above. Approved to accept or retain up to (6) residents on hospice. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: Infection control practices and Personal Protective Equipment (PPEs) were maintained. Staff are trained in the proper use of all required PPEs prior to being around residents. Bathroom has hygiene items such as paper towel, hand soap and toilet paper.

Operational Requirements: Facility has working signal systems in exit points. The facility has a dementia care plan to accept or retain residents with dementia. Staff have the required training to provide special care to dementia residents. Staff cannot provide a copy of the liability insurance during the visit.

Physical Plant/Environment Safety: T he facility is a single story home located in a residential neighborhood which consists of (6) bedrooms, one of which is a staff bedroom, (3) bathrooms, living room with fireplace, family room with a fireplace, kitchen, dining room, laundry area and backyard with patio area. There are currently (5) residents, 60 years and older residing in the facility, (1) is under hospice care. The interior and exterior physical plant was inspected. Resident bedrooms were toured. Each bedroom has a smoke detector, linen, light, chair and sufficient closet space. LPA observed the large sliding door in the staff bedroom is impassable, completely blocked by stacks of boxes. LPA observed that the living room is used for sleeping which was confirmed by a staff member. The fireplaces are adequately screened and inaccessible to residents. Backyard was inspected and has a swimming pool surrounded by a locked gate. There are (2) fire extinguishers in the facility which were serviced on 04/15/2026. Sufficient food supplies of 2 day perishable and at least a week of non-perishable are observed. Knives, cleaning solutions, and disinfectants are locked. Smoke alarms and carbon monoxide were tested and operable. Hot water temperature reading measured within the required 105 - 120 degrees Fahrenheit *****REPORT CONTINUED ON LIC809-C*****