Facility Evaluation Report

On September 23, 2025, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry into the facility by care giving staff after explaining the purpose for the visit. Administrator (AD) Shimon Cagan was notified via telephone but could not arrive to assist with today's inspection. LPA observed that Shimon Cagan has a valid Administrator certificate which expires on November 21, 2025.

The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents and has a hospice waiver for four. The facility is a single story home with four resident bedrooms, two of which can be shared, two shared resident bathrooms, a living room, a dining room, a kitchen, a laundry room, and an attached two car garage. LPA, accompanied by a care giving staff, conducted a tour of the interior portions of the facility. On today's visit, there were four residents in care. LPA inspected the four resident bedrooms and observed them to be free of any hazards. Resident bedrooms had the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed resident beds to have clean linens and blankets. LPA observed additional linens to be stored in a hallway closet. LPA inspected the two shared resident bathrooms. Bathrooms were equipped with grab bars and non-skid floor mats. Faucets and toilets were operational. Hot water temperature measured between 108.1 and 108.8 degrees Fahrenheit.

LPA observed the facility has a two day perishable and a seven day non-perishable food supply in the kitchen. LPA observed kitchen knives and sharps to be stored in a locked kitchen cabinet. LPA observed kitchen appliances such as the refrigerator, stove, and microwave to be clean and operational. LPA observed fire extinguishers to be mounted on the wall in the kitchen and in the resident hallway.