Facility Evaluation Report

On March 12, 2025, Licensing Program Analyst (LPA) Eboni Bentley arrived unannounced for the purpose of conducting a Required-1 year annual inspection. LPA Bentley was greeted and granted entry by staff after stating gthe purpose of the visit. Administrator (AD) Mark Cruz arrived shortly after and was present to assist with the visit. Mark Cruz has an Administrator certificate with an expiration date of December 2, 2026.

The facility is licensed for age range 60 and over, with the for capacity of six (6) Non-Ambulatory residents, and has a hospice waiver for six (6) residents. There are currently four (4) residents present during today’s visit. The facility is a two-story house and the second story consists of: 4 bedrooms, and 3 bathrooms which are utilized for caregivers. The first floor consists of: 4 resident bedrooms; of which 2 bedrooms are shared bedrooms, 2 are private bedrooms, 3 bathrooms, living room, dining area, and kitchen.

LPA Bentley toured the interior and exterior of facility with staff, and the following was observed: There were no bodies of water on the premises, all rooms were inspected, beds and bedding supplies were available, lighting was provided in all rooms, and storage for the residents’ personal belongings were observed in residents’ closets. Additional bed linens, comforters, and bath towels were available during the visit. The water temperature in 3 of 3 resident bathrooms were measured to be between 113.7 and 114.3 degrees Fahrenheit. Grab bars and non-slip mats were observed in all resident bathrooms. The kitchen was clean and organized. All knives and sharp objects were locked in a drawer near the stove. A two-day supply of perishable food items and seven-day supply of nonperishable food items was observed.