Facility Evaluation Report

On 4/7/2025 at 09:30 AM, Licensing Program Analysts (LPA) Eldin Serrano conducted an announced visit to the facility for purpose of Prelicensing evaluation. LPA met with Applicant Carina Davis. An initial application to operate a Residential Care for the Elderly facility (RCFE) was submitted to the Central Applications Bureau (CAB) on 10/15/2024 for a total capacity of six (6) nonambulatory, of which two (2) maybe bedridden and waiver/granted for hospice care for six (6). Fire clearance was granted on 2/5/2025 for six (6) non-ambulatory residents and two (2) bedridden. LPA Serrano observed the following:

Facility was a one (1) story house with five (5) resident bedrooms, and two and half (2.5) bathrooms, living room, dining area/kitchen and laundry. There was an attached two (2) car garage in the left side of the house.

Central heating and air conditioning system installed with one (1) central panel located in the hallway to

Each resident bedrooms accommodate any nonambulatory residents and bedroom #2,#3,#4 is for bedridden resident. All resident bedrooms were adequately furnished with bed, chair, closet, appropriate linens, adequate lighting, nightstands, a lamp and an operable smoke/carbon monoxide alarm.