Facility Evaluation Report

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Annual Continuation Inspection. The LPA identified himself and disclosed the purpose of the visit to Caregiver Ester Villar. The facility was licensed for a capacity of six (6) non-ambulatory residents, of which one (1) may be bedridden. The facility also had a hospice care waiver approved for two (2) residents.

The LPA reviewed the facility Infection Control Plan, Emergency Disaster Plan, and staff and resident records. There were not immediate concerns and the LPA provided technical advise. The facility was clean, sanitary, and in good condition. No deficiencies were observed, nor cited on today's date.

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