Facility Evaluation Report

On 8/4/2026, at 1:30 PM Licensing Program Analysts (LPA) Reza Jamaly arrived unannounced at the facility to conduct the required annual inspection. LPAs met with staff on duty, and explained the purpose of the visit, administrator Lucia Boboc was notified and arrived shortly after.

Facility is cleared for 6 resident non-ambulatory residents, waiver granted for hospice care for 6 residents, current census was 5, per administrator 2 residents left the facility for the family visit.

Firstly, LPA Jamaly inspected the physical plant including but not limited to the common area, kitchen, pantry, dining area, resident's bedrooms, resident bathrooms, laundry room, and outside courtyards of the facility to ensure compliance with Title 22 regulations.

LPA inspected 5 resident's bedrooms and observed bedrooms to be properly furnished with appropriate bedding and lighting. Resident's bathrooms observed to be cleaned, grab bars and non-slip mats were observed to be secure and in good condition. The hot water temperature measured 112.4 at one of the resident bathroom sink, which is within the required range of 105°F to 120°F. Facility temperature was checked at living room and observed to be 77 degree F. There are no bodies of water present.

During the inspection, LPA toured the kitchen and pantry and observed multiple perishable and non-perishable food items that were either expired, spoiled, or marked with manufacturer "Best if Used By" dates that had passed.

In the kitchen, LPA observed seven (7) loaves of bread with visible mold. The bread was labeled with "Best if Used By" dates in February, May, June, and July 2026. LPA also observed at least four (4) packages of wilted vegetables stored in the refrigerator. During the inspection, the Administrator removed the wilted vegetables from the refrigerator.