Facility Evaluation Report

On May 20, 2025, at 10:15 AM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim was greeted and granted entry by Caregiver (CG) Anna Stelle. Administrator (AD) Ameer Attrah arrived at the facility around 11:02 AM and LPA Kim explained the purpose of the visit.

The facility is licensed to operate for six (6) nonambulatory residents, of which one (1) may be bedridden in bedroom #3, and has a hospice waiver for six (6) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) resident bedrooms, two (2) staff rooms, three (3) bathrooms, living area, dining area, kitchen, outdoor covered patio, and a detached two car garage.

LPA Kim toured inside and outside of the physical plant with Licensee Ahmed Attrah. There were no obstructions in the facility. The garage was inspected and the LPA observed the garage has a constructed room and area that has a closet, sink, and a shower that does not reflect in the sketch. The sink and shower are non-operational but have pipes connected through different walls. 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 stocked at the time of visit. The Resident’s rooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, and Resident Room 4. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured at 105.6 degrees F to 113.0 degrees F. A comfortable temperature of 75 degrees F was maintained in the facility.