Facility Evaluation Report

On 05/28/2025 Licensing Program Analyst (LPA) Debbie Palacios conducted an unannounced one (1) year required visit. LPA was granted entry by caregiver, John Hernandez Juliano, who was informed of the purpose of visit; Licensee David Carlson arrived to the facility shortly after. At the time of the visit there was four (4) residents present. All staff present were observed to have obtained proper fingerprint clearance and were associated to the facility. LPA observed the following during today's visit:

LPA conducted a tour of the facility with Licensee David Carlson. The physical plant is a one story structure that contained five (5) resident bedrooms with one (1) shared bedroom, one (1) staff bedroom, and three (3) bathrooms. The facility has a dining room, kitchen, living room, garage, and a gated backyard. Indoor and outdoor passageways were free of obstruction. There were no bodies of water located on the property. The facility has more than a two (2) day supply of perishable food and seven (7) day supply of non-perishable foods. Extra linen were observed in the closet located in the hallway. Dishes and utensils were in sufficient supply and in good repair. Knives and sharp items were observed in a locked cabinet in the kitchen. Resident bedrooms had the required bedding, furniture, and lighting. The smoke and carbon monoxide detectors were tested and were observed to be operable. Centrally stored medications were observed in a locked cabinet near the kitchen area. The outdoor patio was observed to have shaded seating to encourage outdoors socialization. Three (3) fully charged fire extinguishers were observed in the facility last served 01/29/2025. The living room was observed to have board games and other activities. The facility was observed to be in a clean condition; free of dirt, insects, rodents, and pests.