Facility Evaluation Report

Licensing Program Analyst (LPA) Sarah Hurt conducted an announced visit to the facility for purpose of a Pre-Licensing evaluation. LPA arrived and was granted entry to the facility by Administrator, Juanito Estamo Jr. . An initial application to operate a Residential Care Facility for the Elderly (RCFE) was submitted to the Central Applications Unit (CAU) on 07/08/2022 for a capacity of six non- ambulatory residents.

Facility is a two-story house with 6 resident bedrooms, 3 bathrooms, family / living room, dining area and kitchen. There is a 2-car garage attached in front of home. The resident bedrooms will accommodate residents' furnishings.

Central air/heating system installed with a central panel to control entire house.

Bedrooms #1-5 will accommodate 6 clients (one shared room)

All bathrooms have a working toilet, wash basin, and shower.

Adequate supply of linens is stored in garage cabinet.

Emergency Phone Numbers, Exit Plan, and Sample Menu:

Will be posted and readily available for review in the living room.