Facility Evaluation Report

Licensing Program Analyst (LPA) Celine Rodriguez conducted an unannounced visit to the facility for the purpose of conducting the required annual inspection. LPA Rodriguez explained reason for visit and was greeted and granted entry by staff on duty. For this visit, there are 5 residents in care, of which 2 are on hospice. For this visit, LPA Rodriguez met with facility administrator (AD) - Myla Mach.

LPA Rodriguez observed the facility administrator (AD) certificate for Myla Mach which expires on 11/18/2026. LPA Rodriguez observed that the PUB475 "See Something, Say Something" poster was posted in the hallway off the facility.

The facility has a total of eight bedrooms of which six are designated for residents and two rooms designated for staff. Facility is a two-level structure, of which the first floor is designated only for resident use, and it was verified that the second level is only designated for staff.

LPA Rodriguez toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Facility was observed to have 2 bathrooms on the first floor and 1 on the second. Bathrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational.

Hot water was measured at 113.3 degrees Fahrenheit. LPA Rodriguez observed that the facility had a two-day supply of perishables and a seven-day supply of non-perishable food. LPA Rodriguez observed hallways were free of obstructions.