Facility Evaluation Report

License Program Analyst (LPA) Hansen arrived unannounced to conduct an Annual Required – 1 yr. visit of the facility. LPA was welcomed by Administrator Natalia Meyerson. Facility is single story with a loft for staff use only with four (4) resident bedrooms & three (3) bathrooms, with a fire clearance approved for 8 Non-Ambulatory, hospice waiver for 4, and secured perimeter. At today’s inspection there is a total of 6 residents with no residents currently on Hospice.

LPA toured the facility on 9/16/2025 at 8:20 AM with administrator; facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Fire Extinguishers were found to be last charged on 8/8/2025 at the time of the visit. Facility smoke detectors are hard wired and sound directly to contracted company which are inspected annually, last being 9/12/2025. LPA observed carbon monoxide detectors to be operational during the visit. Facility has a generator that will start if there is a power shut off. Hot water temperature measured between 115.3 degrees F and 117 degrees F within Title 22 acceptable regulation of 105 to 120 degrees F in 3 of 3 resident’s bathrooms while touring facility on 9/16/2025 at 8:50 AM. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Food stored in the kitchen refrigerator were properly stored as per regulations at the time of the visit. Food is available for residents any time of the day. There are activities schedule for residents' weekly. Toxins are stored in locked bathroom cabinets, locked kitchen cabinet under sink, and garage. There was a supply of cleaners, hygiene products and paper products available for residents. Bathrooms were equipped with necessary grab bars, and slip-resistant mats, strips, or flooring in all bathtub and shower floors as required by Title 22 regulations. A sample tour of resident’s bedrooms was conducted, and bedrooms inspected have lighting & appropriate furnishing.