Facility Evaluation Report

Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to the facility today to conduct a required annual visit. LPA was greeted and granted entry and explained the reason for the visit. Administrator arrived shortly after

The facility is a two-story home. The first floor houses three shared resident bedrooms, two bathrooms, living room, family room, dining room, kitchen, game room, staff room, covered patio, backyard and 2-car garage. The second floor houses the management office, three staff rooms, one bathroom and loft. The second floor is inaccessible to residents. The facility is licensed for six non-ambulatory residents with an approved hospice waiver for six.

During today’s visit, LPA toured the facility and inspected the physical plant, including but not limited to testing all smoke detectors and testing hot water temperature in two of two resident bathrooms. The hot water temperature measured between 109 and 115 degrees Fahrenheit. The facility’s last emergency drill was conducted on June 5th 2025. LPA inspected the facility food supply and observed the facility retained a minimum of two days perishable and seven days non-perishable food on hand. LPA observed medication storage and reviewed the centrally stored medications.

LPA reviewed two out of two staff training and fingerprint records. LPA conducted a complete review of resident records LPA confirmed that administrator has a current certificate which expires on September 15th, 2026.

Based on observations made during today's visit no deficiencies noted. An exit interview was conducted and a copy of this report was provided