Facility Evaluation Report

On April 28, 2025, at 09:00 AM, the Licensing Program Analyst (LPA) Kiran Jain arrived unannounced at the facility to conduct a Required 1-Year Annual inspection. The LPA met with the A.M. Shift Lead (SLD), Samah Syed, and disclosed the purpose of the inspection. The Interim Program Administrator (ADM), Kyle Liddle, joined shortly after. The SLD informed the LPA that the facility had (3) residents in care and (4) staff members present at the time. (1) resident was away at the hospital and (2) residents were at the facility.

At 9:32 AM, the LPA initiated a walk-through of the facility, accompanied by the SLD.

LPA inspected the kitchen and found it clean, with no food preparation and cooking in progress at the time. The appliances were checked and observed to be in working order. The sink was empty, and no dirty dishes were observed. The refrigerator and pantry cabinets were inspected, and sufficient supplies of fresh perishable food for (2) days and nonperishable staples for (7) days were observed. No expired food or stored medications were noted.

LPA inspected the dining area adjacent to the kitchen and found it clean. The dining table and chairs were observed to accommodate the residents, and all the furniture was in good repair. An additional working refrigerator with freezer was observed in the dining area. LPA inspected the living room and observed it clean, with all furniture in good repair. There were sofas, chairs, television, and a coffee table. A non-slip rug was placed under the coffee table and the sofa. Board games, puzzles, and other recreational activity items for residents’ planned activities were also observed. The indoor temperature reading of 71°F on a thermostat was observed in the hallway at the time of the visit. LPA inspected a locked closet in the hallway, containing detergents, soap, and cleaning supplies.