Facility Evaluation Report

Licensing Program Analyst (LPA) Ruth Martinez made an unannounced visit for the purpose of conducting the required annual inspection. LPA was greeted and granted entry by care staff and explained the purpose for the visit. Administrator Shimon Cagan arrived shortly after and met with LPA. LPA observed that Administrator Shimon Cagan has a valid Administrator certificate which expires November 21, 2027.

The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents and has a hospice waiver for six. There currently are four residents at the facility and there are two residents receiving hospice services currently.

LPA accompanied by Administrator began the tour of the inside and outside of the facility. LPA observed required department postings throughout the facility. Facility stays within the capacity limitations. LPA observed residents to have just finished lunch and about to do activities. There is a minimum of one week of non-perishables foods and two days of perishables foods available. The facility is maintained at a comfortable temperature. LPA inspected that medication is centrally stored in a safe locked storage closet located in the living room. LPA reviewed medication and observed medication was labeled and stored inaccessible to residents in care. LPA observed the first aid kit stores with medication. LPA inspected the facility bathrooms and LPA measured the hot water temperature which measured 111.3 Fahrenheit degrees. All bathrooms observed to have a supply of soap, toilet paper and towels. Bathrooms are equipped with required safety measures such as non-skid mats and grab bars. Lighting is sufficient to ensure safety and comfort. The