Facility Evaluation Report

Licensing Program Analyst (LPA) Ruth Martinez is conducting this case management visit for the purpose of a health and safety check. Five (5) residents currently reside at this location and hospice services are being provided to three (3) residents at this time. LPA arrived at facility was greeted at the door by caregiver and granted entry.

Upon entry LPA observed there was three residents in living room watching TV, one caregiver in living room with residents, one caregiver in kitchen doing meal preparation with one resident in the kitchen, and one resident in their bedroom. During the case management visit LPA took a tour of the inside of the facility, restrooms and common areas. LPA observed the kitchen is clean and organized. LPA observed that the meal prepared appeared of good quality and storage areas organized. LPA inspected food supply adequate amount was observed to be within regulations. The facility has a two-day supply of perishables, and seven-day supply of non-perishable food is available as required by regulations. Knives and sharps objects are kept locked in a kitchen drawer. LPA observed the fire extinguisher charged and mounted in the wall in the kitchen with service date of April 9, 2025. LPA inspected that medication is centrally stored in a safe locked storage closet located in the bedroom hallway of the facility. LPA reviewed medication and observed medication was labeled and stored inaccessible to residents in care. LPA observed all resident rooms had the required furnishings. LPA observed all resident rooms are clean and organized. The facility stays at a comfortable temperature. LPA observed bathroom was clean and operational. LPA measured the hot water temperature which measured 117.8 Fahrenheit Degrees. LPA inspected the garage; door is kept locked. LPA observed the following an emergency food supply and water, there is a spare refrigerator with additional