Facility Evaluation Report

On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to conduct a required annual visit. LPA was greeted and granted entry by staff and explained the reason for the visit.

The facility is a four bedroom single story building with an approved fire clearance of six non-ambulatory residents of which four may be on hospice. The facility currently has a census of five residents in care.

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 111.3 and 117.3 degrees Fahrenheit and all smoke detectors were operational. The swimming pool is fenced and locked and inaccessible to residents. The facility conducted an emergency drill on June 18, 2026. 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 observed emergency food and water in the laundry room.

LPA reviewed three staff training and fingerprint records and conducted a complete review of five out of five resident records. LPA confirmed that administrator has a current administrator certificate which expires on February 15, 2027.

No deficiencies noted, an exit interview was conducted and a copy of this report was provided.