Facility Evaluation Report

On 09/09/2025, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA met with Facility Designated Administrator, Sarah Mikail and explained the purpose of the visit.

Current census was 3. 3 out 3 residents were out at their respective day programs.

This facility is licensed to serve and accept up to 6 residents who are deemed to be ambulatory only. This facility is also vendorized to accept and retain Level 2 residents at this time. Census was currently at 4. Tour of the facility was conducted.

LPA reviewed 2 staff files and 3 resident files. All of which are current and up to date. The administrator has a current administrator certificate #6010139735 and expires on 10/08/2025.

Fire extinguisher located in the kitchen and office was serviced by Assured and is valid until 10/20/2025. Smoke detectors and carbon monoxide was present and in good repair.

Dining areas, living areas, and all other areas intended for resident use were toured. It was observed that furniture and furnishings were sufficient and able to meet the needs of the residents at this time.

Kitchen area was toured. Food storage units were reviewed for adequate 2-day perishable and 7-day non perishable quantities at this time.

LPA Pascua observed a locked centralized stored medication cabinet located in the living room. Along with Administrator, the LPA observed, reviewed, and compared resident medication with the medication dispensing logs. First Aid Kit was present and contained all of the required components.