Facility Evaluation Report

Licensing Program Analyst (LPA) Nancy Guillen made an unannounced visit for the purpose of conducting a required annual Inspection. LPA was greeted and granted entry by care staff after explaining the purpose of the visit. LPA observed Administrator (AD) Carmen Achim’s certificate was current with an expiration date of December 01, 2027. This is a Residential Care Facility for the Elderly (RCFE) licensed to six non-ambulatory residents and an approved hospice waiver for three. The facility is a one-story home with six resident bedrooms, one staff bedroom, seven restrooms, a living room, family room, dining room, kitchen and two car garage.

During the inspection, LPA and staff conducted a tour of the inside and outside of the facility, common areas, resident rooms, garage and observed the following:

LPA observed five residents in care and two staff present. LPA observed the See Something Say Something Poster (PUB 475) mounted on the wall in the living room. LPA observed that all resident bedrooms had the required furnishings. LPA observed all resident beds had linens and blankets with additional linens stored a hallway closet. LPA observed bathrooms were clean and equipped with grab bars and non-skid floor mats. Bathrooms were observed to be free of debris and mildew. Faucets and toilets were operational. Water temperature tested between 105.8 and 113.3 degrees Fahrenheit. LPA observed all windows were appropriately screened. LPA toured the outside of the facility and observed outdoor passageways were free of obstruction. LPA observed the backyard had a shaded sitting area with furniture for resident use.