Facility Evaluation Report

Licensing Program Analyst (LPA) Anthony Tuck arrived to conduct an unannounced annual inspection on 04/22/2022. LPA met with Administrator Maria Teresa Sanchez and explained the purpose of the visit. Maria Teresa Sanchez is the Administrator and holds certificate #6009456740 that expires on 12/16/2023

This facility is a single story building licensed to serve six (6) non-ambulatory residents. Facility is approved for (4) hospice residents at any time. LPA toured the physical plant including but not limited to two resident bedrooms, two resident bathrooms, and backyard area. LPA observed the facility to be free of odor, clean and in good repair. LPA observed sufficient furniture and lighting throughout the facility. There are no bodies of water present.

LPA observed sufficient seven day non-perishable and two day perishable food supplies. Hot water temperature was measured at (108) degrees Fahrenheit in the bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Fire extinguishers and smoke and carbon monoxide detectors are in compliance with fire safety. Fire extinguisher last serviced 02/16/2022. Thermostat observed at (75) degrees Fahrenheit. LPA observed centrally stored medications, toxins and sharp knives kept locked and inaccessible to clients. LPA reviewed staff associations to the facility. First aid kit was checked and is complete.

The following forms were obtained during today's visit on 04/22/2022:

LIC 500, certificate of liability insurance

No deficiencies were cited during today's visit. Exit interview held with Maria Teresa Sanchez and a copy of report given at the conclusion of the visit.