Facility Evaluation Report

On 4/22/26, Licensing Program Analyst (LPA) Kyle Wellington arrived unannounced to conduct an annual inspection. LPA was greeted and let into the facility by Caregiver, Cristina Agoscruz, who was informed of the purpose of the visit. Administrator (Admin), Garrett Welker, arrived shortly thereafter to the facility to meet with LPA. LPA observed two (2) staff and four (4) residents present at the facility. The census at the facility is five (5) residents with one (1) resident in the hospital. Two (2) residents are receiving hospice care.

LPA received a staff and resident roster from the Caregiver. LPA toured the inside and outside of the facility with the Caregiver. LPA conducted an observation and record reviews for the inspection.

Facility Overview: The facility is a one story house with six (6) resident bedrooms, one (1) staff room, two (2) resident bathrooms, one (1) staff bathroom, kitchen, dining room, family room, laundry room and attached garage. There were no pools, bodies of water or firearms at the facility. Facility has a fire clearance to serve six (6) non-ambulatory elderly residents of which one (1) may be bedridden. Facility has an approved hospice waiver for six (6) residents.

Infection Control: LPA observed hand soap dispensers and hand sanitizers throughout the facility. Cleaning equipment and cleaning supplies were kept locked in the garage and available for regular facility maintenance. LPA reviewed the facility’s infection control plan which met the department’s requirements.

Physical Plant: LPA observed the inside and outside of the facility to be clean, safe and well kept. The floors, windows and doors were clean and well maintained. The family room and dining room furniture was