Facility Evaluation Report

At approximately 2:30 PM, Licensing Program Analyst (LPA) Julie Fl orio arrived unannounced to conduct a required 1-year annual inspection and quarterly non-compliance visit. LPA met with Teresita Buenavista, Caregiver. Licensee was contacted via telephone by caregiver and was unable to attend today's visit. LPA attempted to contact Administrator and left them a voicemail. LPA did not receive a returned phone from Administrator during visit. Neither Licensee nor Administrator were present for today's visit. LPA was informed the facility is closing and Licensee is working on issuing 60-day notices informing the residents formally of the facility's closure. LPA was informed that Licensee is assisting the current residents with new facility placement.

Facility is a Residential Care Facility for the Elderly (RCFE) with two (2) residents in care. Facility has a Dementia Care Plan, a Hospice waiver for two (2), and is approved for 4 non-ambulatory residents, two (2) of whom may be bedridden. Facility currently has one (1) Hospice residents in care.

Facility is currently on Non-Compliance for the following reasons:

Lack of Liability Insurance in the proper amounts.

Lack of proper funds to properly maintain facility.

LPA toured the facility to ensure residents were safe and secure and that there was proper amounts of food stores, power, water and heat. Facility was a comfortable temperature and had power, water, and heat. Food stores were sufficient to sustain residents in care for seven (7) days as required per regulation.