Facility Evaluation Report

On June 11, 2025, at 8:00am, Licensing Program Analyst (LPA) Eboni Bentley conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Bentley was greeted and granted entry by Caregiver (CG) Leticia Bitas. Administrator (AD) Elvie Ringor met with LPA and was present during the visit. AD Elvie Ringor has an administrator certificate with an expiration date of September 5, 2026.

The facility is a single level structure, licensed for six (6) non-ambulatory residents, of which one (1) may be bedridden and has a hospice waiver for six (6) residents. The home consists of the following: Four (4) resident bedrooms, one (1) staff bedrooms, three (3) bathrooms, a living room area, dining room area, kitchen, outdoor shaded seating area, and an attached two car garage.

There are three residents on census, all present during today’s visit. LPA obtained copies of pertinent documents, including facility records, clients/staff rosters, Personnel Record (LIC500), and clients/staff records.

During the visit, LPA Bentley toured the interior and exterior of the physical plant with AD Ringor and the

following was observed: There were no bodies of water or obstructions on the premises. All rooms were

inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for

each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately