Facility Evaluation Report

On December 26, 2024, 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 House Manager/Administrator (AD) Dennis Macatangay. Administrator (AD) Rose Palma (formerly Rose Jovan) arrived at the facility around 8:30am, and later Licensee Lise Brick.

The facility is licensed to operate for six (6) non-ambulatory residents 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: five (5) resident bedrooms, (1) staff bedroom, two (2) bathrooms, living room area, dining area, kitchen, an outdoor covered seating area, and an attached two car garage.

Around 9:30am, LPA Bentley toured the inside and outside of the physical plant with AD Palma. 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, and storage for each resident’s personal belongings was observed. Five (5) residents were present at the time of visit. The Resident’s rooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, Resident Room 4, and Resident Room 5. Bathrooms were found to be clean and operational. The water temperature measured at 115.4 degrees F to 119.0 degrees F. A comfortable temperature of 72 degrees F was maintained in the facility.

LPA Bentley observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. Emergency safety drills were last conducted on September 16, 2024 and conducted quarterly. First aid kit is maintained and contains all the necessary elements.