Facility Evaluation Report

Licensing Program Analyst (LPA) Sommer Hayes arrived unannounced to conduct a Required - 1 Year visit on 06/13/25 at 2:00pm. LPA met with Niomi Massaquoi and stated the purpose of today’s visit. The most current emergency drill was conducted on 06/01/25 at 7:30am.

The facility is licensed for a capacity of 6 residents of which 5 may be non-ambulatory and 2 may receive hospice care services. There is 1 resident receiving hospice care services during this visit. LPA toured and inspected the physical plant inside and outside to ensure there are no safety hazards to residents. LPA observed 2-day perishables and 7-day non-perishables.

The temperature inside the facility was observed to be 68 F which is within the required range of 68-85*F. The hot water temperature was measured at 119 F which is within the required range of 105-120 F. LPA observed a fire extinguisher, smoke and carbon monoxide detectors, and central heating and air in the facility.

LPA observed the centrally stored medications area to be locked and inaccessible to residents. The first aid kit contained the required items such as a guide, sterile dressings, bandages, adhesive tape, scissors, tweezers, thermometers, and antiseptic solution.

LPA reviewed 3 resident records and 2 staff records. LPA observed the backyard of the facility. There was a shaded area for residents to enjoy. Fencing was in good repair. There were no bodies of water.