Facility Evaluation Report

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual and met with caregivers, Christine Dixon and Shirley Kay Spence, who contacted the Administrator, Ana Maria Cai, who arrived shortly. LPA observed (5) residents in their rooms at the start of the inspection and (1) resident in the common area. The facility is licensed for (5) non-ambulatory residents, (1) bedridden resident and has a hospice waiver for (2). Currently, there are (0) residents on hospice.

LPA and the Administrator toured the interior and exterior of the facility including the common areas, (4) private resident bedrooms, (1) shared resident bedroom, (3) resident bathrooms, kitchen, staff room and laundry area. LPA observed the facility to be clean, in good repair and odor-free, and the bathrooms have the necessary grab bars, slip resistant flooring and hygiene supplies. LPA observed sufficient 2+day perishable and 7+day non-perishable supply of food, and locked sharps and medications in the kitchen. Toxins are locked in the laundry area. There is an additional freezer in the laundry room. Inside temperature read 74*F, and the hot water temperature measured 108*F in the kitchen. The smoke/monoxide alarms functioning, and the fire extinguisher was last serviced 8/15/25. There is a new First Aid kit, and PPE supplies and linens/towels/blankets on site. Residents use a pendant to call for assistance. There is (1) unlocked exit in the backyard and covered seating on the patio. Discussed updates to regulations.

LPA reviewed (2) resident files and (3) staff files. Files were organized and contained current documentation. Medications were reviewed for (2) residents. Orders match medications, and documentation is maintained. All staff have completed the required training, including First Aid/CPR. Administrator's RCFE Certificate #7012558740 is valid thru 9/5/26. Updated insurance policy information obtained. There are no deficiencies issued during today's inspection. Exit interview with Administrator. Copy of report provided.