Facility Evaluation Report

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection and met with staff, Jhamil Espino, Jacob Espino and Administrator, Janelyn Kelly. Several health care staff and family members visited during today's inspection. The facility is licensed for (6) residents, (5) of whom may be non-ambulatory and (1) may be bedridden. There is (1) resident currently on hospice. (4) residents were eating lunch in the dining room at the start of the inspection.

LPA and Administrator toured the interior/exterior of the facility including the common areas, (6) private resident bedrooms, (4) resident bathrooms, kitchen, laundry, and activity area. LPA observed the facility to be clean, in good repair and odor-free. Bathrooms have the necessary grab bars, skid-resistant flooring, shower chair, trash can and hygiene supplies. There is sufficient 2+day perishable, including fresh produce, and 7+day non-perishable supply of food, as well as an emergency supply of food/water. Sharps and toxins are locked are in the kitchen. There are sufficient linens/towels/blankets and PPE supplies. Inside temperature measured 72*F and hot water measured 109* in the kitchen. Fire extinguisher last service d June 8, 2026 . Required postings are visible in the common area. Outside, there is (1) unlocked exit gate and walking trail in the back and a front courtyard . There are non-audio cameras in the common areas.

LPA reviewed (2) resident files and (4) staff files. Files are complete and contain current documentation. Medications were reviewed for (2) residents- orders match medications being administered. Facility uses an electronic record system. Administrator has current RCFE Administrator certificate. All staff are cleared and associated. Copy of current insurance obtained. LPA requested updated LIC308 and LIC500 by 7/28/26. There were no deficiencies observed. Exit interview. Copy of report provided.