Facility Evaluation Report

On 7/27/23 at 9:58 am, Licensing Program Analyst (LPA) Chavez conducted a pre-licensing visit to the facility noted above. LPA met with Janelyn Castaniaga, Applicant. This is a change of location application. A dementia program was included in the plan of operation. A Hospice Waiver has been approved for four (4) residents.

At 10:01 am, LPA conducted a physical plant tour with the applicant of the inside and outside of the facility. There are zero (0) residents occupying the facility. The facility is a one-story building. An approved fire clearance was received, clearing the facility for six (6) non-ambulatory residents; zero (0) ambulatory residents; and, zero (0) bedridden residents. The facility has three (3) private resident bedrooms with a capacity of two residents per room . All resident rooms have direct exits to the outside. Resident rooms have beds, nightstands, lamps, and closet space. Each room has only one chair. Applicant will place an additional chair in resident rooms (3). Resident room #1 is missing two (2) chests of drawers, room #2 is missing one chest of drawers, and room #3 is missing two dressers. Applicant will add furniture to rooms and send photos to LPA. Room #2 has a closet with two doors. One door opens fully, the other does not due to the bed abutting it. Applicant will make an adjustment so that residents have full access to the closet. Applicant will correct the door so it moves freely and send video to LPA. The beds are furnished with box springs, comfortable mattress and clean linen which includes top and bottom linens, pillowcases, blanket (if needed) and a bedspread. Beds are missing mattress pads. Applicant will add mattress pads and send photos to LPA. Lighting in the rooms appeared adequate. The rooms are equipped with overhead fans and lighting. There is a switch by the door to turn lights/fan on/off and chains on the fans to turn each on/off. LPA advised applicant to leave the light chain on so that when residents enter the room and click the light switch on the wall, the overhead light comes on.