Facility Evaluation Report

On 01/28/2026, Licensing Program Analyst (LPA) Janette Romero arrived unannounced to conduct a required annual inspection. LPA was greeted and granted entry by Caregiver Orchideja Bucital who was informed of the purpose of the visit.

Licensee Biljana Ribich was present, met with LPA, and also informed of the purpose of the visit. The facility has a fire clearance to serve six (6) non-ambulatory residents ages 60 and above. The facility also has an approved hospice waiver for six (6) residents and LPA was informed five (5) residents are receiving hospice services at the facility.

LPA toured the facility with Licensee Ribich and observed the facility is made up of a one-story home with six (6) resident bedrooms, a bathroom, kitchen, dining room, and attached garage. The facility has an in-ground pool in the backyard that is secured with a locked gate. Indoor and outdoor passageways are free of obstruction. Resident bedrooms had the required bedding, furniture, and lighting. Bathrooms had grab bars and non-skid mats in the showers. The facility has more than a two-day supply of perishable foods and seven-day supply of non-perishable food items. Medications are secured in a locked kitchen cabinet. LPA toured the garage and observed additional incontinent supplies, pillows, bedding, linens, food and water. Cleaning solutions are secured in the locked garage. Licensee tested one of the smoke alarms/carbon monoxide detectors and LPA observed it to be operational. LPA also observed a fire alarm pull station and a charged fire extinguisher mounted in the facility that was last serviced on 01/07/2026. The facility's certificate of liability insurance expires on 10/31/2026. Staff present has a criminal record clearance and is associated with the facility. Resident files reviewed had updated physician's reports and all the required records. LPA reviewed the facility's Fire Drill Record noting their last fire drill was conducted on 01/03/2026. Complaint information, facility sketch, and emergency phone numbers are visibly posted near the front entrance. During today's visit, LPA did not observe any issues or concerns. An exit interview was conducted and a copy of this report was reviewed and provided to Licensee Ribich.