Facility Evaluation Report

On today;s date, Licensing Program Analyst (LPA) William Vanegas made an unannounced visit for the purposes of conducting an annual inspection. Upon arrival LPA was greeted and granted entry to the facility by facility staff. LPA explained the nature of the visit, and Administrator (AD) Maria Tente was notified, and arrived shortly after to assist with the annual inspection. LPA began a tour accompanied with AD and observed the following. AD has a valid Administrator certificate that is valid from December 4, 2024 thought December 3, 2026

The facility is a two storied home with eight bedrooms, five of which are resident rooms, and three of which are staff rooms, five bathrooms two of which are private resident bathrooms, two of which are shard resident bathrooms, and one of which is a staff bathroom, and an attached two car garage. LPA observed the kiten area to be clean and free of any mildew. LPA observed there to be a refrigerator, microwave, gas stove, dishwasher, washer and a dryer in the facility. All appeared to be in good condition and tested operational. LPA observed a two day supply of perishable food, and a seven day supply of non-perishable food as well a sufficient amount of emergency water on hand.

LPA observed all resident rooms to be free of any hazards and debris. LPA observed all bedrooms to have all required furnishings including a bed, clean linens in good repair; meaning no strains or tares, a chest of drawers, a reading lamp, and enough storage for personal belongings. LPA observed resident bathrooms to be clean and free of any mildews and debris. Water faucets and toilets tested operational. Hot water temperature tested between 113.4 and 117.3 degrees Fahrenheit, grab bars, slip resistant floor matts and shower chair were observed to be in resident bathrooms. CONTINUED ON LIC809-C