Facility Evaluation Report

Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to the facility today to conduct an Annual Required Evaluation. LPA was greeted and granted entry by Staff #1 (S1) . During today’s visit, LPA met with Kian Pascual, Administrator Designee (AD).

The facility is a five bedroom , two bathroom single-story home with an approved fire clearance of six non-ambulatory residents of which one may be bedridden . Five residents are approved for hospice. The facility currently has a census of five residents in care.

During today’s visit, LPA toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors, testing hot water temperature in two of two resident bathrooms, and testing auditory devices on all exits . The hot water temperature measured between 109.4 and 112.1 degrees Fahrenheit and all smoke and carbon monoxide detectors were operational . The fire extinguisher is charged and was serviced on December 3, 2024 and an appointment for service is scheduled on December 9th from 12-3pm. The facility’s last fire drill was conducted on September 9, 2025. This quarter's fire drill will take place by the end of this week.

LPA inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand. Water and emergency supplies were located in the front closet and garage. A weekly menu was posted on the refrigerator door. All stove burners and appliances were operational. The sharps and knives drawer had a lock that needed repair but facility brought in a person to fix the lock prior to LPA's exit. LPA confirmed lock is in working order.