Facility Evaluation Report

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to conduct an Annual Required Evaluation. LPA was greeted and granted entry by Staff #1 at 8:40am. LPA met with Administrator (AD) Cotilia Dahabreh and explained the purpose of the visit.

The facility is a single-story residence with seven bedrooms and three bathrooms. The approved fire clearance is for six non-ambulatory residents with a hospice waiver for three. Currently there are six residents in care, of which three are on hospice.

During today's visit, LPA toured the facility and tested auditory devices on all exits, LPA tested the hot water temperatures in three of three bathrooms; which measured between 105.6 to 110.8 degrees Fahrenheit. All carbon monoxide and smoke alarms were operational. The fire extinguisher was charged and serviced on February 26, 2025. The last fire drill was conducted on September 2, 2925.

LPA toured the kitchen and observed the facility had two-day perishable and seven-day non perishables on hand. There are canned goods in the garage with emergency supplies and water. Sharps and knives were locked in a drawer and all cleaning supplies were secured in the garage. All appliances were in working order, including the washer and dryer. Resident rooms had all of the required furnishings and clean linens.

LPA toured the exterior and observed a shaded seating area and a fenced hot tub which is not accessible to residents. There are two exterior gates and there were no hazards or obstacles in pathways. The PUB 475 poster was posted. LPA reviewed the centrally stored medications and medications are being given as prescribed. (Continued on LIC 809-C)