Facility Evaluation Report

Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility for the purpose of conducting 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) William Young was notified via telephone and later arrived to assist with the inspection. LPA observed that Administrator William Young has a valid Administrator certificate on September 27, 2025.

The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents, of which six can be bedridden, and has a hospice waiver for six. The facility is a single story home with six private resident bedrooms, three shared resident bathrooms, two living rooms, a dining room, a kitchen, and an attached two car garage. LPA, accompanied by the AD conducted a tour of the interior portion of the facility. On today's visit, LPA observed five residents in care, two of which are on hospice, and three staff present. LPA observed residents relaxing in their respective bedrooms and in common areas. LPA observed the See Something, Say Something poster (PUB 475) mounted on the wall in the kitchen. LPA inspected the six private resident bedrooms and they were observed to be free of hazards. LPA observed residents bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed resident beds had clean linens and blankets. LPA observed additional linens to be stored in a hallway closet. LPA observed the auditory exit alarms to be operational in all resident bedrooms. LPA inspected the three shared resident bathrooms. Resident bathrooms were clean. Resident bathrooms were equipped with grab bars and non-skid floors. Faucets and toilets were operational. Hot water temperature measured between 112.8 and 114.8 degrees Fahrenheit.