Facility Evaluation Report

On April 28, 2026, Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced required visit using the CARE Inspection Tool. LPA was greeted by staff and granted entry after stating the purpose of the visit. Direct Care Staff Juliet Gines arrived shortly after arrival to assist with the facility inspection. Licensee Ricardo Banos arrived later to assist with visit.

The facility is licensed for six (6) non-ambulatory residents of which one may be bedridden with approved hospice waiver for four (4) residents. Currently, there are four (4) Hospice residents present during today’s visit.

This is a single story with attached garage facility. The facility has five bedrooms (four private resident rooms and one shared resident room), and five bathrooms.

LPA conducted a tour of the physical plant accompanied by Direct Care Staff, and the following was observed: There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the client's personal belongings, toxins and sharps was observed. Bathrooms were operational with water temperature measured between 111.3 to 118.4 degrees F. A comfortable temperature of 73 degrees F. was maintained in the facility.

LPA observed the facility to be furnished at the time of the visit. The kitchen was inspected, and sufficient perishable and non-perishable food was maintained adequately. A fire extinguisher was charged, facility has two fire extinguishers. A review of the Medication Records Administration (MAR) was conducted, and LPA observed the records are in compliance. CONT on 809C