Facility Evaluation Report

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection and met with Balwinder Rai, Administrator, and stated the reason for today's inspection. Also present were care staff Yasmin Bennett and Veron Reid, and a hospice nurse for (1) resident. LPA observed (2) residents watching television in the common area and (3) residents in their rooms. The facility is licensed for (3) bedridden residents, (3) non-ambulatory residents and is approved for (6) hospice residents.

LPA and the Administrator toured the interior/exterior of the facility including the common areas, (4) private resident bedrooms, (1) shared resident bedroom, (3) full resident bathrooms, (1) half resident bathroom, kitchen, laundry/garage. LPA observed the facility to be clean, in good repair and have sufficient furniture and lighting. Bathrooms have the necessary grab bars, non-skid flooring, soap, paper towels, and hand-washing poster. There is 2+day perishable, including fresh produce, and 7+ day non-perishable food. Sharps and medications are secured in the kitchen. Toxins are locked in the laundry area. Hot water measured 113*F in the kitchen. Inside temperature measured 75*F. Smoke/monoxide alarms are working, and the fire extinguisher was last serviced 3/18/25. There are sufficient linens/towels/blankets/PPE and a complete First Aid kit. There is (1) unlocked exit gate and covered patio seating. There are no pools/ponds.

LPA obtained updated facility contact information. (2) resident files and (3) staff files were reviewed. Files were organized and contained current documentation. Initial/ongoing staff training is documented. Medications/orders were reviewed for (1) resident. There were no discrepancies noted, and PRN medications are documented. RCFE Admin #6058964740 is pending renewal (verified). Admin Designee has RCFE #607271174- (exp 10/8/26). The Plan of Operations has the updated Dementia Care Regulations. LPA obtained current insurance information. LIC308 and LIC500 to be emailed to LPA by 4/29/25.

There were no deficiencies observed. Exit interview. Copy of report provided to the Administrator.