Facility Evaluation Report

On 05/21/2026 at 09:00 AM, Licensing Program Analyst (LPA) Beena Singh made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Licensee/Administrator Jacqueline Dillard and was granted entry to the facility. At the time of the visit, there were one (1) staff present, and one (1) resident present.

The facility is a two (2) bedroom, one (1) bathroom home with a kitchen/dining area, living room/activity room and a garage. The facility is Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of four (4) non-ambulatory residents. The facility’s approved for four (4) hospice waiver. The current census is one (1) resident. LPA was accompanied by Licensee/Administrator Dillard to conduct a general overall inspection, which included, but was not limited to the following:

Physical Plant : The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 75 degrees Fahrenheit (F). LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathroom was clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperatures in the bathroom to be at 110 degrees F. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Fire extinguishers were also observed at the facility. Posters such as personal rights, the CCLD complaint poster, labor laws, and the disaster plan were posted in a common area.