Facility Evaluation Report

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection and initially met with Kanika Townsy, caregiver, who contacted the Administrator by phone. LPA observed (2) residents watching television in the common area while lunch was being prepared (3) residents were resting in their rooms. Administrator, Cristina Ivascu, arrived around 1:15 pm. The facility is approved for (5) non-ambulatory residents, (1) bedridden, and has an approved hospice waiver for (6) residents. Currently there are (2) residents under hospice care.

LPA toured the interior/exterior of the facility including the common areas, (2) private resident bedrooms, (2) shared resident bedrooms, (2) resident bathrooms, kitchen, laundry and garage. LPA observed the facility to be clean, in good repair and to have sufficient furniture and lighting throughout and both bathrooms have the necessary grab bars, skid-resistant flooring, and hygiene products. There is sufficient 2+day perishable, including fresh produce, and 7+ day non-perishable food. There is a small refrigerator for refrigerated medications in the kitchen. Sharps, toxins and mediations are locked in the kitchen. There is (1) unlocked exit and no pools. All exits are free from any blockages. Staff are aware of where utility shut off valves are.

LPA reviewed (2) resident files and (3) staff files. Files are organized and contain the required paperwork. LPA reviewed medication and orders for (1) resident- there were no discrepancies noted. Staff is completing training as required, including for First Aid/CPR certifications. Administrator has current RCFE certificate ## 7011737740 (exp 6/5/2026). All staff are cleared/associated. Annual fee are by 3/5/2026. Insurance is current.

There are no deficiencies cited in this report. Exit interview. Copy of report provided.