Facility Evaluation Report

Licensing Program Analyst (LPA) Celine Rodriguez conducted an unannounced required 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. During the visit, staff on duty contacted facility administrator (AD) Cherryl Sansano about visit. For this visit, there are 3 staff members on duty, of which are background cleared and associated.

The PUB475 "See Something, Say Something" poster was observed to be located at the entrance of the facility. Per CDSS administrators certification website, the administrator's certificate for Cherryl Sansano renewal application has been received as of 8/23/2025 and is still pending.

LPA toured the interior and exterior portions of the facility with AD Sansano. The facility is a two-level structure and is licensed for 6 residents, of which 6 may be non-ambulatory, 1 may be bedridden (to only be located in bedroom #3) and 4 may be on hospice. For this visit, there are a total of 6 residents in care, of which 1 is on hospice.

On the first floor, there are a total of 4 resident bedrooms, of which 2 are private resident rooms, and 2 are shared resident rooms. LPA 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. On the first floor, there are a total of 2 restrooms designated for resident use. Restrooms were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. On the second floor, there are 2 bedrooms and 1 bathroom, of which is only designated for staff use.