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 staff after explaining the purpose of the visit. Administrator (AD) Daniel Datcu was notified via phone and later arrived to assist with the visit. LPA observed the administrator certificate was current with an expiration date of March 12, 2028. This is a Residential Care Facility for the Elderly (RCFE) licensed to six non-ambulatory residents with a hospice waiver for four. The facility is a one-story home with six resident bedrooms, one staff bedroom, four bathrooms, a living room, kitchen, dining room and an attached garage.

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

LPA observed residents watching television in their respective bedrooms. LPA observed six residents in care and three staff present. LPA observed the See Something Say Something Poster (PUB 475) mounted 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 in a shared bathroom cabinet. LPA observed bathrooms were clean and equipped with grab bars, toilet paper, paper towels, 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 and 110.4 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.