Facility Evaluation Report

On May 8, 2025 at 1:45 PM, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility for the purpose of conducting the required annual inspection. LPA was greeted and granted entry into the facility by care giving staff after explaining the purpose for the visit. Administrator (AD) Vijay Kanase was notified via telephone and later arrived to assist with the inspection. LPA observed that Administrator Vijay Kanase submitted a Administrator renewal application to the Administrator Certification Bureau (ACB) on April 14, 2025.

The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents, of which one can be bedridden, and has a hospice waiver for four. The facility is a single story home with four resident bedrooms, two of which are shared, three resident bathrooms, a living rooms, a dining room, a kitchen, a laundry room, and an attached two car garage. LPA, accompanied by the AD conducted a tour of the interior portion of the facility. On today's visit, LPA observed four residents in care and three staff present. LPA observed residents relaxing in their respective bedrooms and in common areas. LPA observed the See Something, Say Something poster (PUB 475) mounted on the wall by the entryway of the facility. LPA inspected the four resident bedrooms and they were observed to be free of hazards. LPA observed residents bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed resident beds had clean linens and blankets. LPA inspected the three resident bathrooms and observed them to be free of hazards. Resident bathrooms were equipped with grab bars and non-skid floors. Faucets and toilets were operational. Hot water temperature measured between 123.6 to 123.8 degrees Fahrenheit.