Facility Evaluation Report

On 8/28/2023, Licensing Program Analyst (LPA) Janette Romero arrived unannounced at the facility to conduct an annual required visit. LPA was greeted and granted entry by Caregiver Anthony Mike Vito who was informed of the purpose of visit. During the visit, five (5) residents and two (2) staff present.

The facility is approved to care for six (6) non-ambulatory residents of which one (1) may be bedridden. The facility has a hospice waiver for 6. The facility is made up of four (4) resident bedrooms, two (2) bathrooms, a kitchen, dining room, living/family area, laundry room and garage.

During the visit, LPA observed the following:

Kitchen: LPA observed kitchen to be clean. Food is stored in a safe and healthful manner. The facility has a 2-day supply of perishable food items and 7-day supply of non-perishable food items. Sharps are secured in a locked kitchen drawer.

Dining and Living room: LPA toured the dining and living/family room area. LPA observed areas to be clean and furniture in good condition. LPA observed residents watching television in the living room and sleeping in their rooms. Fire extinguisher is charged and mounted in the dining room.

Hallway : LPA observed hallway to be clean with no pathway obstruction. Carbon monoxide and smoke detector were tested and functioning properly.