Facility Evaluation Report

On June 25, 2025 at 1:15 PM Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim was greeted and granted entry by Caregiver (CG) Mavern Nichol. Administrator (ADMIN) Bahira Hanna was contacted over the phone and LPA explained the purpose of the visit. ADMIN Hanna stated to LPA Kim that they would not be able to attend today’s visit and CG Nichol could sign on the facility’s behalf.

The facility is licensed to operate for six (6) non-ambulatory, of which 1 may be bedridden and have a hospice waiver for four (4) residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: Six (6) resident bedrooms, one (1) staff bedroom, three (3) bathrooms, living area, dining area, attached 2 car garage, kitchen, and an outside covered patio area.

LPA Kim toured indoor and outdoor of the physical plant with CG Suzette Robinson. There are no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. All bedrooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, Resident Room 4, Resident Room 5, Resident 6, and Staff Room 1. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured at 115.8 degrees F and 117.8 degrees F. A comfortable temperature of 78 degrees F was maintained in the facility. LPA Kim observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, and sharps objects were stored and not accessible to residents. .