Facility Evaluation Report

Licensing Program Analyst (LPA) Rankin arrived at 8:46 am to conduct a 1-year annual visit to the facility above. LPA met Administrator/Licensee Miriam and Hans Salamanca and explained the purpose of the visit.

A tour of the inside and outside of the facility was conducted with Administrator. The following was inspected and noted during the annual visit:

Physical Plant & Environmental Safety: The facility has 3 bedrooms and 2 bathrooms, currently occupying 3 residents. The facility is clean, safe, and sanitary. LPA was authorized to enter and inspect facility. The facility has smoke and carbon monoxide detectors that were working at time of visit. The lighting and lamps are sufficient for the use of the facility and for resident’s comfort. The showers have non-skid mats present. Toilet, hand washing and bathing facilities are operational and secured grab bars are present. The pathways are clear of any obstructions. Disinfectant, cleaning solutions and poisons are inaccessible to residents in care and locked in garage. The facility has sufficient space inside and outside for activities and visiting. The facility has a backyard/side yard and patio for resident use with plenty of shade. The facility has telephone and internet service for resident use.

Operational Requirements: The facility has a current plan of operation. The Facility is operating in compliance with the granted fire clearance. The facility has current liability insurance and expires on 12/31/2024. The facility is approved for a capacity of 6 non-ambulatory and has a current Hospice wavier granted for 2. Facility will be submitting a Hospice Waiver for 3 resident.