Facility Evaluation Report

At approximately 9:35AM, Licensing Program Analyst (LPA) Felias arrived unannounced to conduct a 1-Year Required Visit and met with Licensee/Administrator, Erik Flatt and Adam Waskow, and Administrator, Matthew Riformo. Facility serves residents with dementia and has a plan of operation for dementia care and programming on file. Facility has an approved fire clearance for 6 non-ambulatory residents and 2 bedridden residents for a total capacity of 6 residents. Facility has an approved hospice waiver for 3 individuals. Upon arrival, LPA was informed that there were 5 Residents in care and 2 staff members on-site.

LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. LPA reviewed staff files. Staff files had current First Aid and CPR certification. Administrator's Certificates for Erik Flatt (7005115740), Adam Waskow (7014460740), and Matthew Riformo (7013848740) were current with expiration dates of 06/28/2026, 01/16/2026, and 02/15/2027. Facility's last emergency/disaster drill was conducted September 2025.

LPA discussed the following topics with Licensees and Administrator:

LPA unable to complete annual visit. Annual continuation to be conducted at a later date.

Exit interview conducted. Copy of report discussed and provided to Licensee/Administrator. Signature on form confirms receipt of documents.