Facility Evaluation Report

Licensing Program Analyst (LPA) Celine Rodriguez conducted an unannounced visit for the required annual inspection. LPA Rodriguez explained the purpose of today’s visit, and was greeted and granted entry by staff on duty, who informed facility administrator (AD) Ray Santianez about visit. For this visit, LPA Rodriguez met with AD Santianez.

For today’s visit, LPA Rodriguez observed a total of 6 residents in care of which 4 are on hospice, 1 bedridden, and 4 staff members on duty.

LPA Rodriguez observed the Administrator's Certificate for Minerva Sansano which expires on 4/9/2026 and Ray Santianez which expires on 8/18/2027. LPA Rodriguez observed the PUB 475 "See Something Say Something" poster located at the entrance of the facility.

LPA Rodriguez toured the interior and exterior portions of the facility with staff on duty. The facility is a single level structure and is licensed for 6 non-ambulatory residents, of which 1 may be bedridden, and 2 may be on hospice, however facility has an approved waiver for 4 residents to be on hospice. There are a total of 5 bedrooms, of which 2 are shared resident rooms, 2 private resident rooms, and 1 room for caregivers. 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. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. There are a total of 2 restrooms in the facility. Restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature tested and observed to be between 109.3 to 113.2 degrees Fahrenheit.