Facility Evaluation Report

Licensing Program Analyst (LPA) Sabrina Calzada arrived at the facility unannounced to conduct a Required annual Inspection. LPA met with Lydia Copaciu, Administrator, and Eugene Copaciu, staff, stating the reason for today's inspection. LPA observed (2) resident present in the common area and (2) residents in their rooms. Currently, there are (2) residents on hospice. The facility is licensed for (6) non-ambulatory residents and has a hospice waiver approved for (4) residents.

LPA and Administrator toured the interior/exterior of the facility including common areas, (3) resident bedrooms, (2) resident bathrooms, kitchen, laundry/garage area. The upstairs area is used by staff. LPA observed the facility to be clean, in good repair and odor-free, and each bathroom has the necessary grab bars, non-skid flooring, paper towels, trash can with lid and 20-second hand-washing poster. Medications are locked in a designated closet, and toxins are locked in the kitchen/laundry area. The inside temperature measured 79*F and the hot water measured 107*F in the kitchen. Sharps are locked in kitchen. There is 2+day perishable food, including fresh produce, and 7+ day non-perishable food. There are sufficient paper products/PPE/linens/towels and (2) complete First Aid kits. The fire extinguisher was last serviced 7/9/2025. Quarterly fire drills are conducted with residents- last drill July 2025. Outside, there is a covered patio table with chairs and two open, unlocked exits for evacuation. Required postings are in the common area. Updated Dementia Care paperwork on file with the Plan of Operations.

LPA reviewed (2) resident files and (2) staff files. Files were organized and contain current documentation. Medications were reviewed for (1) resident-orders were current and match medications. Staff have completed current training- RCFE Administrator cert #7005901740 (exp 9/11/26). LIC308 and LIC500 to be emailed by 7/25/25. Updated insurance information obtained.

There were no deficiencies observed. Copy of report provided during exit interview.