Facility Evaluation Report

The Department received a notice from the Licensee of a fire clearance change request on 05/13/2024. The Licensee reported the request would be submitted to change the fire clearance from six (6) ambulatory residents to six (6) non-ambulatory residents. An inspection of the facility was completed on the above date. The LPAs inspected the interior and exterior areas of the home. The home appeared to be adequately maintained for the care of non-ambulatory residents. No health and safety concerns were observed at the time of the inspection.

An exit interview was conducted and this report was reviewed with Angelica Ubungen, licensee, and a copy was provided.