Facility Evaluation Report

Licensing Program Analyst (LPA) Rebecca Borunda conducted an unannounced case management visit to continue the Required 1-Year visit from 9/23/2025. LPA identified herself to and explained the purpose of the visit with General Manager Charles Bloom.

The facility has a licensed capacity of 95 non-ambulatory residents, 32 may be bedridden on 1st floor only and has a waiver for 20 hospice residents. The Administrator for the facility is Charles Bloom and their certificate was valid and current. During visits on 9/23/25 and 10/9/25, LPA toured the facility and inspected a random sampling of resident rooms, private and common bathrooms, kitchen, common areas, and outside space. No bodies of water were observed on the premises. LPA did not observe any aspects of secured perimeter. The facility was found to be clean, safe, and in good repair with no pathway obstructions. The facility’s ambient and water temperature were measured within regulatory requirements at multiple locations. LPA observed locked storage for resident medications and hazardous and/or toxic chemicals, both of which were stored separately from food supplies. According to Charles Bloom, no firearms or weapons are stored on the premises. LPA observed a minimum supply of 2-days of perishable food and 7-days of non-perishable food. The facility refrigerator and freezer were kept within requirements. Staff present at the facility during the time of the inspection had a criminal background clearance and association. LPA reviewed multiple resident and staff records. LPA was away from the facility between 12:05pm and 1:05pm.

No deficiencies were cited on today’s date. An exit interview was conducted with General Manager Charles Bloom, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 3/22).