Facility Evaluation Report

Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to the facility today to conduct an Annual Required Evaluation. LPA was greeted and granted entry by staff and explained the reason for the visit.

Facility is licensed for six non-ambulatory residents of which one may be bedridden. Facility has an approved hospice waiver for four residents and the facility has no residents on hospice during today's visit.

During today’s visit, LPA toured the facility and inspected the physical plant, including but not limed to testing all smoke detectors, testing hot water temperature in four out of four resident bathrooms. The hot water temperature measured between 106.1 and 112.4 degrees Fahrenheit and all smoke detectors were operational. The facility’s last fire drill was conducted on October 15th, 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. Per review medications are being given as prescribed. LPA Mendivil observed emergency food and water in facility pantry and garage.

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

No deficiencies noted during today's visit. An exit interview was conducted and a copy of this report was provided.