Facility Evaluation Report

On December 8, 2025, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry into the facility by care giving staff after explaining the purpose for the visit. Licensee Elena Bor was notified via telephone and later arrived to assist with the inspection. LPA observed that Elena Bor has a valid Administrator certificate which expires on June 17, 2027.

The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents and has a hospice waiver for six. The facility is a two story home. Only the first floor of the home is licensed to provide care and supervision and it consist of: five resident bedrooms, one of which is shared, five resident bathrooms, a living room, a dining room, a family room, a kitchen, a laundry area, and a detached two car garage. LPA, accompanied by the LI, conducted a tour of the interior portions of the facility. On today's visit, LPA observed six residents in care and two care giving staff present. LPA observed the See Something, Say Something poster (PUB 475) mounted on the wall by the resident hallway. LPA inspected the five resident bedrooms and observed them to be clear of any hazards. LPA observed resident bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed resident beds to have clean linens and blankets. LPA observed additional linens to be stored in hallway cabinets. LPA inspected the five resident bathrooms and observed them to be clean. Resident bathrooms were equipped with grab bars and non-skid floor mats. Faucets and toilets were operational. Hot water temperature measured between 116.6 and 117.1 degrees Fahrenheit.

LPA observed the facility has a two day perishable and a seven day non-perishable food supply in the kitchen. CONTINUED ON LIC809-C