Facility Evaluation Report

Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to the facility today to conduct a required annual. LPA was greeted and granted entry by staff and explained the reason for the visit.

The facility is a level 4f, single story building with an approved fire clearance of six ambulatory residents of which one may be on hospice. The facility currently has a census of five clients in care.

During today’s visit, LPA toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors. All smoke detectors were operational. The facility’s last fire drill was conducted on October 21st 2025. 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 medication storage and reviewed the centrally stored medications. LPA observed activities in the form of board games and arts/crafts.

LPA reviewed four out of four staff training and fingerprint records. LPA conducted a complete review of client records. LPA confirmed that administrator has a current administrator certificate which expires on August 12th, 2026.

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.