Facility Evaluation Report

On 4/14/2025, Licensing Program Analyst (LPA) Janette Romero made an unannounced visit to the facility to conduct a required annual inspection. LPA was greeted and granted entry by Caregiver, Christina Agoscruz who was informed of the purpose of the visit. One of the facility administrators, Garrett Welker arrived to the facility to meet with LPA. The facility has a fire clearance to serve six (6) non-ambulatory elderly residents of which one (1) may be bedridden. The facility also has an approved hospice waiver for six (6) and LPA was informed two (2) residents are currently receiving hospice services at the facility. During today's visit, there was three (3) staff and six (6) residents present.

LPA toured the facility with Agoscruz and observed the facility is made up of a one-story home with six (6) resident bedrooms, three (3) restrooms, a kitchen, dining area, living room, laundry room, and attached garage. Resident bedrooms had the required bedding, furniture, and lighting. Bathrooms had grab bars and non-skid mats in the showers. No bodies of water were observed on the premises. Indoor and outdoor pathways were free of obstruction. The facility had more than a two-day supply of perishable foods and seven-day supply of non-perishable foods. Medications are secured in a locked kitchen closet. LPA toured the garage and observed an additional incontinent supplies, cleaning solutions and disinfectants stored separately from the food and water. Agoscruz tested one (1) of the smoke alarms/carbon monoxide detectors and LPA observed it to be operational. LPA also observed a charged fire extinguisher mounted near the kitchen last serviced on 11/1/2024. The facility's certificate of liability insurance expires on 5/1/2025. Staff present have a criminal record clearance and are associated with the facility. Resident files reviewed had updated physician's reports and signed admission agreements. LPA reviewed the facility's Fire & Emergency Disaster Training noting the facility's last fire drill was conducted on 4/1/2025. Long Term Care Ombudsman's contact information, residents' personal rights, complaint procedures and facility sketch are visibly posted near the front entrance. During today's visit, LPA did not observe any issues or concerns. An exit interview was conducted and a copy of this report was reviewed and provided to Administrator Welker.