Facility Evaluation Report

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced Case Management visit in regards to updates made to the facility layout/floor plan. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to caregivers Eleanor Weber and Oscar Rosario. LPA also spoke with Licensee/Administrator Luka Subotic over the phone.

The facility had notified the Department on 2/5/26 of construction completed to add two (2) more bedrooms to the home, changing the number of designated resident bedrooms from four (4) to six (6). No changes to facility capacity or ambulatory status capacity were requested. A new fire inspection was requested by the Department to review the proposed floor plan and determine if the new rooms were ready for occupancy. Community Care Licensing received an approved fire clearance on February 26th, 2026, approving the new floor plan.

The facility is approved for a capacity of six (6) residents, all of which may be non-ambulatory. Additionally, the facility has a hospice waiver for four (4). Currently, the facility has no approval for bedridden residents. During today's visit, LPA conducted a tour of the facility and confirmed that the updated facility sketch was consistent with the current layout of the facility. The new rooms were furnished and one already occupied.

No immediate health and/or safety concerns were observed during today's visit. The updated facility sketch will be forwarded to management for final review/approval. An exit interview was conducted with caregiver Rosario to whom a copy of this report was provided. Their signature below confirms receipt of this document.