Facility Evaluation Report

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection and met with Sherry Cort, Administrator Designee. Also present was Arshdeep Kaur, volunteer staff. Administrator Sukhman Sahota arrived around 11:15 am. LPA observed (1) resident leave with a family member to go on an outing and (3) residents resting in their rooms at the start of the inspection. The facility is licensed for (6) non-ambulatory residents, (1) of whom may be bedridden, and has a hospice waiver for (2) residents. Currently no residents are under hospice care.

LPA and Administrator Designee toured the interior/exterior of the facility, including common area, resident bedrooms, (3) resident bathrooms, kitchen, laundry and garage. LPA observed the facility to be clean, in good repair and to have sufficient furniture and lighting throughout. The bathrooms have the necessary grab bars, non-skid flooring, soap, and paper towels. There are locked sharps, toxins and medications in the kitchen. There is sufficient 2+day perishable, including fresh produce, and 7+day non-perishable supply of food. Hot water measured 113.5*F in the kitchen. Fire extinguisher was last serviced on 9/24/2025, and there is a complete First Aid kit. All exit doors have alarms. There are sufficient PPE/paper supplies and linens/towels/blankets as well as flashlights and night lighting. There are multiple required postings posted near the front entrance, including the Emergency Disaster Plan and Theft & Loss Policy. There are games/activities and an operating land line. There is a covered patio with table and chairs and (2) unlocked exit gates. There are storage sheds.

LPA reviewed (4) of (4) resident files and (2) staff files. Files were organized and contained current documents. Medications were reviewed for (2) residents- medications are being logged appropriately. Administrator to request updated medication lists for (2) residents. Staff have completed required training, including First Aid/CPR, and RCFE Administrator Certificate #6072086740-exp 9/30/2026. *cont on 809C-1.