Facility Evaluation Report

Licensing Program Analysts (LPA) B. Miranda conducted an unannounced visit today for the facility’s annual inspection. LPA introduced themselves and was allowed entrance into the facility. LPA met with DSD Nurse Nicole Lowe Ciuffo.

Facility is licensed for 76 residents and has a current census of 38. Nicole stated currently there are no residents on hospice and 1 resident with home health. Home Health Plan was reviewed. Water temperature was checked in 2 different wings in the facility, first bathroom water temperature read at 113.1 degrees Fahrenheit and the second bathroom read at 106.3 degrees Fahrenheit. Fire Extinguishers were serviced March 18, 2026 and is within the safety regulation period. Carbon monoxide detectors were tested and in working order. Facility had the annual inspection for the sprinkler system on February 12, 2026, and passed with no concerns.

Basuny Eldaouch Administrator's Certification expires November 20, 2026. Staff files were reviewed, and not complete at this time. Resident files were reviewed, and some are not complete. First aid kit on site and complete. There is a locked storage are for medications.

LPA inspected the interior and observed the exterior of the facility including the common areas, resident bedrooms, bathrooms, medication storage, and kitchen. Bedrooms are clean, properly furnished, with adequate lighting, and in good repair. Food supply is adequate for 2-day perishable and 7-day nonperishable.