Facility Evaluation Report

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection, met with Georgiana Nath, Administrator Designee, and stated the reason for today's inspection. The facility is licensed for (1) ambulatory, (4) non-ambulatory and (1) bedridden resident and is approved for (2) hospice residents. Currently there is (1) resident on hospice. Care staff, Maria Venzeac, was present in the common area with (1) resident who was receiving a pedicure/manicure from a licensed manicurist.

LPA and Administrator toured the interior/exterior of the facility including the common areas, (4) private resident bedrooms, (1) shared resident bedroom, (2) resident bathrooms, kitchen, laundry and staff room. 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, paper towels, and a 20-second hand-washing poster. There is a complete First Aid kit. There is sufficient 2+ day perishable food, including fresh produce, and 7+ day non-perishable food. Sharps/toxins are locked in the kitchen and medications are secured in a separate area. Hot water measured 105*F in the kitchen and the inside temperature measured 75*F. Fire extinguishers were last serviced on 3/28/25. Smoke/monoxide alarms are in working order. There are sufficient linens/towels/blankets/PPE/incontinent supplies. There are (2) open unlocked exits and outdoor covered seating. There are no pools/ponds.

LPA reviewed (2) resident files and (4) staff. Files were organized, complete and contained current documentation. Medications were reviewed for (1) resident- medications administered match orders and are being documented, including PRN dosages. All staff are cleared/associated and (3) staff have current RCFE Administrator Certifications. Staff have completed required initial training and have current First Aid/CPR certifications. Discussed updates to Dementia Care Plan of Operations- to be obtained. LPA requested current LIC500 and LIC308 by 5/6/25. There were no deficiencies observed.

Exit interview. Copy of report provided to the Administrator Designee.