Facility Evaluation Report

Licensing Program Analyst LPA Samer Haddadin conducted an unannounced visit for the purpose of completing annual inspection. LPA was greeted and granted entry by staff member, Rani Abbas. LPA and staff member began the tour and observed the following: The facility is a one-story resident with a detached two-door garage. The facility has a total of four bedrooms, three full bathrooms with no clients in care at the time of the visit.

NO residents were observed in the facility. LPA checked all four bedrooms and observed all to have the required furnishing: clean linens, chair night stand room for storage and enough lightning. Hard wired smoke detectors, carbon monoxide and audible exit alarms were tested to be operational. Fire extinguisher was checked and observed it to be full charge with last inspection date of Dec.1st,2025. Bathrooms were observed to be in good repair and provided with grab bars and hot water was measured between 115.6-116.6 degrees Fahrenheit. Facility did meet the minimum two-day supply of perishable and seven-day supply of non-perishable food stock requirements. Emergency Food and water was also available and stored in the garage For the exterior portion, facility had a shaded area with char for residents ; grounds were free of tripping hazards and ample space for activities. Facility has a 2-car garage and is kept locked and used for storage; the garage also had an operational washer and dryer. kitchen was in good repair with cleaning supplies and sharp items locked in cabinet. LPA observed a locked cabinet in hallway which will be used for meds.

Based on today’s visit , LPA completed the pre-licensing inspection and an exit interview was conducted and a copy of this report was given and left with staff members

LPA advised that the facility must advise LPA once they receive in their first resident