Facility Evaluation Report

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection and met with Estelita Cailing, Administrator and Adam Dickey, Co-Administrator/Member. LPA observed (2) residents present and was advised (2) residents were currently attending day program. (1) resident left to day program around 11:00 am. The facility is a Level 5 home and has a hospice waiver for (1). Currently, no residents are under hospice care.

LPA and Co-Administrator toured the interior/exterior of the facility, including the common areas, (4) client bedrooms, (2) client bathrooms, (1) staff room, (2) additional bedrooms, (1) staff bathroom, and laundry room. LPA observed the facility to be clean, in good repair and odor-free and the bathrooms to have the necessary grab bars, skid-resistant flooring and hygiene items. There is sufficient 2+day perishable, including fresh produce, and 7+day non-perishable supply of food. Sharps and toxins are locked in the kitchen. Medications and additional toxins are locked in the laundry area. Inside temperature measured 70*F and hot water measured 118*F in the kitchen. The fire extinguisher was last serviced 9/23/2025, and the smoke/monoxide alarms are functioning. There is a complete First Aid kid. Required postings are in the common area as well as the current Administrator Certificate #7036196740- (exp 3/28/27). Co-Administrator has current RCFE Administrator #7023412740 (exp 9/28/26). Resident doors have locks and resident were issued a key if desired. There is a perimeter fence but no gate in the front. There is a gated/locked pool on the property. There is an alert on front exit door and other exit doors. LPA reviewed (2) resident files and (7) staff files- files are very organized and contain current documentation, including required staff training. Medications were reviewed for (1) resident- orders match medications being administered. P&I funds were reviewed for (2) clients- funds match records. LPA obtained new land line. Updated Dementia care plan to be added to Plan of Ops. Current insurance, updated LIC308 and LIC500 obtained. There are no citations issued in this report. Exit interview. Copy of report provided.