Facility Evaluation Report

On October 2, 2025, Licensing Program Analyst (LPA) Murial Han conducted an unannounced annual inspection. Upon entrance, LPA was greeted by caregiver Delilah Nicodermus and LPA explained the purpose of the visit. House Manager Rosita Padolina and Administrator, Katie Eiseman arrived shortly thereafter and assisted with the annual inspection.

The facility is licensed for a capacity of 6 non-ambulatory residents of which 3 may receive hospice care services. There are 2 residents receiving hospice services at this time.

LPA toured the facility inside and outside including the bedrooms (4 private and 1 shared rooms), 1 full- bathroom, kitchen, living room and common areas. Staff rooms are located on the 2nd floor. The facility observed to clean, tidy and in good repair. Bedrooms were equipped with the required furniture for residents to use. Bathroom is equipped with grab bars, and in good condition. Facility temperature is comfortable. Hot water temperatures in the kitchen and bathroom was measured at 105- 110 degrees F. LPA observed 2-day perishables and 7-day non-perishables.

LPA observed a pull alarm system, fire extinguisher(s), smoke and carbon monoxide detectors in the facility. Fire extinguishers were last inspected on 8/8/2025.

Medication, and disinfectants were observed to be locked and inaccessible to residents.