Facility Evaluation Report

On November 7, 2025, Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced required visit using the CARE Inspection Tool. LPA was greeted by staff and granted entry after stating the purpose of the visit. Staff contacted Administrator Rose Ang to notify of visit. Administrator Rose Ang arrived at 9:07AM and was available to assist with the facility inspection.

The facility is licensed for five (5) non-ambulatory and one (1) ambulatory residents with approved hospice waiver for four (4) residents. Facility serves as a Residential Care Facility for the Elderly and Dementia. Currently, there are two (2) Hospice residents present during today’s visit.

This is a single story with attached garage facility. The facility has five bedrooms (two private resident rooms, two shared resident rooms and one staff room) and two resident bathrooms and one staff bathrooms.

At around 9:15AM , LPA conducted a tour of the physical plant accompanied by Administrator Rose Ann Ang, and the following was observed: There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the client's personal belongings was observed. Bed linens, comforters, and bath towels were available during the visit. Bathrooms were operational with water temperature measured at 105.8 to 118.9 degrees F in resident restrooms. A comfortable temperature of 74 degrees F. was maintained in the facility.

LPA observed the facility to be furnished at the time of the visit. Storage areas for personal hygiene, cleaning products and sharps objects were stored and not accessible to residents.