Facility Evaluation Report

On this Day,Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to conduct a required annual inspection. LPA was greeted and granted entry into the facility and explained the reason for the visit.

The facility is a one story building with an approved fire clearance for six non-ambulatory residents of which 1 may be bedridden and a hospice waiver is approved for four residents. The facility has a current 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 and testing the hot water temperatures in bathrooms. The hot water temperatures measured between 113 to 115.1 degrees Fahrenheit. LPA observed all smoke detectors were operational. The facility’s last emergency drill was conducted on April 15th 2026. 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. LPA observed secured medication storage in kitchen cabinet. LPA observed emergency food and water in the facility garage.

LPA reviewed two out of two staff training and fingerprint records. LPA conducted a complete review of resident records. LPA confirmed that administrator has a current administrator certificate which expires on May 23rd 2026, LPA confirmed renewal of administrator certificate has been completed and is currently pending.

Based on the observations made during today’s visit no deficiencies cited on this date . An exit interview was conducted and a copy of this report was provided.