Facility Evaluation Report

Licensing Program Analyst (LPA) made an unannounced visit to the facility to deliver deficiencies identified through the comprehensive annual licensing inspection that commenced on September 15, 2025. LPA identified themselves to Med-Tech Bartolome and was granted entry into the facility.

The facility is licensed to serve six (6) residents; of which all of whom may be non-ambulatory and/or receiving Hospice Services, and 1 resident may be bedridden. The facility’s current census is five (5) residents, and all 5 residents were present.

During today’s visit LPA conducted a brief facility tour and rendered deficiencies for four (4) violations, identified by a prior visit for the continuation of the annual inspection. In addition, LPA in collaboration with Med-Tech Bartolome created plans of corrections

Deficiencies were cited during today's visit and are listed on the LIC 809D pages. A copy of the LIC 809 and deficiencies LIC 809D, and the License Appeal Rights (01/2016) will be provided at the conclusion of the visit, and signature on this form acknowledges receipt of the rights and a copy of this report.