Facility Evaluation Report

Licensing Program Analyst (LPA) Samer Haddadin conducted an unannounced annual inspection of the facility. Upon arrival, LPA Haddadin was greeted by Administrator Eric Lin, who granted entry and was advised of the purpose of the visit. LPA toured both the interior and exterior of the facility and made the following observations.

The facility is a single-story building with six private rooms and an approved fire clearance for six non-ambulatory residents, of which one may be bedridden. The facility is also approved to serve up to six residents receiving hospice care. At the time of this visit, five residents were present in the facility, two of whom were on hospice.

All resident bedrooms were inspected and found to be appropriately furnished with a bed, chair, and clean linens, provided adequate storage, and were free of tripping hazards. The kitchen was in good repair, with all major appliances operational. Sharps and knives were secured and inaccessible to residents.

The exterior of the facility was well maintained. Furnishings were in good repair, pathways were unobstructed and free of hazards, and the grounds appeared safe and inviting, with a shaded seating area available.

Fire extinguisher was fully charged, with indicators in the green zone. The most recent inspection date was September, 2024. Hot water temperature was measured at 113.3 degrees Fahrenheit, which is within regulatory requirements. Records indicated that the last emergency drill was conducted on July 20, 2025.

The facility maintained sufficient food supplies, including at least two days’ worth of perishable items and seven days’ worth of nonperishable items. A review of resident files revealed no discrepancies.