Facility Evaluation Report

Licensing Program Analysts (LPA) Erik Zaragoza conducted a a subsequent unannounced Annual Continuation visit using the full Care Compliance and Regulatory Enforcement (CARE) Tools. The initial visit was conducted on 11/24/2025. LPA met with Monica Guardian, and explained the purpose of the visit. There are eighty-eight (88) residents currently living in the facility.

The following 12 (CARE) tool domains were observed and reviewed: Infection Control, Physical Plant/Environment Safety, Operational Requirements, Staffing, Personnel Records/Staff Training, Resident Rights/Information, Resident Records/Incident Reports, Food Service, Planned Activities, Incident Medical and Dental, Disaster Preparedness, and Residents with Special Health Needs.

· The facility is a two-story building that contains the following: First floor consists of resident rooms with individual bathrooms, 1 living room, Dining Rooms, courtyard, office rooms, medication room, kitchen, and laundry area. The second floor of the facility consists of the following: resident bedrooms with individual bathrooms, laundry room, outdoor porch seating area, and Activity room. LPA toured eight (8) resident bedrooms, and all of them had hot water temperatures that measured within the required 105 – 120 Degrees Fahrenheit range. The facility was observed to be in good repair. Carbon Monoxide detector is operational.

· The interior and exterior physical plant was inspected. Exit doors are free of any obstruction. The facility has multiple fully charged fire extinguishers throughout the facility.