Facility Evaluation Report

Licensing Program Analyst (LPA) Rankin arrived at 8:55 am to conduct a 1-year annual visit to the facility above. LPA met Administrator/Licensee Miriam Salamanca and explained the purpose of the visit.

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

Physical Plant & Environmental Safety: The facility has 3 bedrooms and 2 bathrooms, currently occupying 2 residents. The facility is clean and sanitary. The facility has smoke and carbon monoxide detectors that were tested and working at time of visit. The lighting and lamps are sufficient for the use of the facility and for residents’ comfort and safety. The showers have non-skid mats present. Toilet, hand washing and bathing facilities are operational and secured grab bars are present. The indoor pathways are clear of any obstructions. Disinfectants, cleaning solutions and poisons are 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 residents with plenty of shade.

Operational Requirements: The Facility is operating in compliance with the granted fire clearance. The facility has current liability insurance and expires on 6/1/2026. The facility is approved for a capacity of 6 non-ambulatory and has a current Hospice wavier granted for 3.

Staff Personnel Records & Training: The facility has two full-time Administrators on staff. Staff records are kept confidential. LPA reviewed 2 staff files for required forms and signatures, Files had required documents available for review. Files have education/Training for renewal of Administrator Certificates present. One administrator certificate expires on 09/27/26 and another Administrator certificate will expire 3/13/27.