Facility Evaluation Report

On today's date Licensing Program Analyst (LPA) William Vanegas made an unannounced visit for the purposes of conducting an annual inspection. LPA was greeted and granted entry to the facility by Administrator (AD) Elena Gherman. LPA explained the purpose of the visit and began a tour of the facility accompanied by AD. LPA observed the following.

The facility has been licensed since April 6, 1998. Per AD there have never been any residents admitted into the facility. All licensing fees were reviewed and observed to be up to date and current. Licensee advised LPA that they do not plan on admitting any residents at this time, due to recent unexpected events that occurred in their personal life. However licensee wishes to keep their license active at this time in the even that they do decide to admit residents at a sooner date.

LPA observed the facility to be a single storied home that has two structures. One front home and one back home. AD advised that the front home is where the AD and their husband will continue to reside. The back home is where the facility will operate out of. The back home was observed to have three bedrooms, a fully furnished kitchen, and two bathrooms. The resident rooms were observed to have all required furnishings including a chest of drawers, a bed, clean linens, a reading lamp, and enough storage space to store personal belongings; all through there are no residents in care at this time.

LPA toured the outside of the facility and observed the following. There is debris and several large objects around the exterior of the entire property. There is a fountain with no large bodies of water in it. LPA advised AD that significant improvements need to be made prior to them admitting any residents to the facility. AD understood and advised everything will be fixed before any residents are admitted. CONTINUED ON LIC809-C