Facility Evaluation Report

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Required Annual Inspection. The LPA introduced himself and disclosed the purpose of the visit to Caregiver Michelle Rodriguez. Administrator Felicity Arcangeli arrived during the visit and assisted the LPA. The facility was licensed for a capacity of fifteen (15), of which twelve (12) could be bedridden. The facility was also approved for a hospice waiver for five (5) residents.

The LPA, accompanied by staff, toured the interior and exterior of the facility, and inspected each room. The facility

was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms

contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order.

The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities.

There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored.

Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to clients.

Medications were labeled and stored in locked areas. No pools or bodies of water on the premises. Per staff, no firearms or ammunition are kept at the facility. Smoke detectors detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present. Required licensing postings were observed in visible areas of

LPA interviewed staff and reviewed multiple staff and client records/files.

No deficiencies were cited during today's annual inspection.

An exit interview was conducted with Administrator Arcangeli,, to whom a copy of this report and, the Licensee/Appeal Rights (LIC9058) were provided.