Facility Evaluation Report

On April 8, 2026, Licensing Program Analyst (LPA) Garlli Tat made an unannounced visit to the facility to conduct a Case Management inspection. LPA was greeted and granted entry to the facility by staff after explaining the purpose for the visit. Administrator (AD) Janine Cuyson was notified via telephone, answered questions over the phone, and provided verbal agreement that caregiver Lesly Dacula can sign the report on her behalf.

On today's visit, LPA observed that the facility currently has a census of four residents. LPA observed residents watching television and sleeping in the living room and their own rooms. LPA, accompanied by staff, conducted a tour of the physical plant of the facility. LPA inspected the four resident bedrooms (2 shared and 2 private bedrooms), living room, kitchen, dining room, and the attached two car garage. LPA observed them to be free of hazards. The garage is used for storage and laundry. LPA observed residents bedrooms to have the required furnishings of a bed, a chair, a dresser, and a lamp. LPA observed resident beds to have clean linens and blankets. LPA observed the lights in each of the resident's bedroom to be operational. LPA inspected the two bathrooms located in the facility. LPA observed bathrooms to be clean and operational. Bathrooms were equipped with grab bars and non-skid floor mats. Hot water temperature measured between 110.8 and 112.6 degrees Fahrenheit. Fire extinguisher was maintained on March 23, 2026.

LPA observed the facility has a two day perishable and seven day nonperishable food supply located in the pantry. LPA observed kitchen appliances to be clean and operational. LPA observed the four burner gas stove lights unassisted. Continued on LIC 809-C.