Facility Evaluation Report

On 3/27/2025, Licensing Program Analyst (LPA) Janette Romero made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Licensee, Snezana Lukic and Administrator, Tania Lukic who was informed of the purpose of the visit. The facility has a fire clearance to serve six (6) non-ambulatory elderly residents. The facility also has an approved hospice waiver for three (3) and LPA was informed three (3) residents are currently receiving hospice services at the facility. During today's visit, there was two (2) staff and six (6) residents present. Licensee's administrator certificate expires on 7/7/2025.

LPA toured the facility with Lukic and observed the facility is made up of a one-story home with six (6) resident bedrooms with restrooms, two (2) bathrooms, a staff room, kitchen, dining room, living room, laundry room, and staff office. Resident bedrooms had the required bedding, furniture, and lighting. Bathrooms had grab bars and non-skid mats in the showers. No bodies of water were observed on the premises. Indoor and outdoor pathways were free of obstruction. The facility met Departmental requirements for a two-day supply of perishable foods and seven-day supply of non-perishable foods. Medications are secured in a locked kitchen cabinet. Administrator tested one (1) of the smoke alarms/carbon monoxide detectors and LPA observed it to be operational. LPA also observed a charged fire extinguisher mounted near the entrance. The facility's certificate of liability insurance expires on 5/5/2025. Staff present have a criminal record clearance and are associated with the facility. Resident files reviewed had updated physician's reports and Departmental required records. The facility reported they do not manage the residents' cash resources. LPA reviewed the facility's Fire Drill & Evacuation log noting the facility's last fire drill was conducted on 2/20/2025. Long Term Care Ombudsman's contact information, residents' personal rights, complaint procedures, facility sketch, and emergency phone numbers are visibly posted near the front entrance/living room. 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 Lukic.