Facility Evaluation Report

On August 4, 2026, at 1:45 PM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim met with Administrator (ADMIN) Jill Bonnin and explained the purpose of the visit .

The facility is licensed to have a capacity of four (4) nonambulatory residents and a hospice waiver for two (2) residents. LPA Kim observed the following. The facility is a one-story house with an attached 2-car garage with four (4) resident bedrooms, two (2) bathrooms, dining room, a kitchen, a living room, outdoor shed, and outdoor shaded area.

LPA Kim toured inside and outside of the physical plant. There are no obstructions or bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. All bedrooms were inspected: Resident room 1, Resident Room 2, Resident Room 3, and Resident Room 4. Bathrooms were found to be within Title 22 regulations and were clean and operational.. The water temperature measured between 105.7 degrees F and 106.7 degrees F. A comfortable temperature of 74 degrees F was maintained in the facility.

LPA Kim observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents