Facility Evaluation Report

At approximately 9:35AM, Licensing Program Analyst (LPA) Hansen arrived unannounced to conduct a Case Management – Inspection visit, and met with Executive Director, AnneMarie Domizio. The purpose of the visit is to follow up on approved Fire Clearance of facility.

Community Care Licensing (CCL) received approved Fire Clearance for facility on 7/7/2026. During today's inspection, LPA observed a handful of resident rooms, they have been checked and approved by fire. On 6/22/2026 while completing annual inspection of facility, LPA Hansen discovered four (4) out of the eight (8) resident showers not being functional. During today’s inspection six (6) out of the eight (8) resident showers were observed to be functioning.

Administrator agrees to submit self-certification when final repairs are completed on last showers.

LPA conducted interviews and obtained additional documents.

Exit interview conducted. Copy of report discussed and provided to Executive Director. Signature on form confirms receipt of documents.