Facility Evaluation Report

On 12/15/2025, Licensing Program Analyst (LPA) Janette Romero made an unannounced visit to the facility to conduct a required annual inspection. LPA was greeted and granted entry by Assistant Administrator (AA), Keith Pollard who was informed of the purpose of the visit. Administrator, Sameh Awad was phoned also informed of the purpose of LPA's visit. The facility has a fire clearance to serve six (6) non-ambulatory elderly residents of which one (1) may be bedridden. The facility also has an approved hospice waiver for two (2) and LPA was informed only one (1) resident is currently receiving hospice services at the facility. Staff present has a criminal record clearance and is associated with the facility.

LPA toured the facility with AA Pollard and observed the facility is made up of a one-story home with five (5) resident bedrooms, one (1) bathroom, a kitchen, dining area, living room, laundry room, and attached garage. Resident bedrooms had the required bedding, furniture, and lighting. The bathroom had a grab bar and a non-skid mat in the shower. No bodies of water were observed on the premises. Indoor and outdoor pathways were free of obstruction. The facility had more than a two-day supply of perishable foods and seven-day supply of non-perishable foods. Medications are secured in a locked kitchen cabinet. AA Pollard tested one (1) of the smoke alarms and carbon monoxide detectors and LPA observed them to be operational. LPA also observed two (2) charged fire extinguishers mounted in the facility. Cleaning solutions and chemicals are secured in the locked laundry room. The facility has several towels, bedding and linens available in different colors for the residents in care. The facility's certificate of liability insurance expires on 02/17/2026. LPA reviewed the facility's Drill Log noting the facility's last fire drill was conducted on 11/18/2025. Long Term Care Ombudsman's contact information, residents' personal rights, complaint procedures and facility sketch are visibly posted in the facility. No citations were issued during today's visit. An exit interview was conducted and a copy of this report was reviewed and provided to AA Pollard.