Facility Evaluation Report

On November 4, 2025, Licensing Program Analyst(LPA) John Calandra, arrived at the facility to conduct the Annual 1-year required inspection. LPA Calandra was greeted by Mark Williams, Administrator and explained the purpose of the visit.

LPA Calandra toured the physical plant. This is a 2-story building (residents only live on the first floor) with 4 bedrooms and 2 bathrooms, a backyard, front yard, kitchen, living room, dining room, and sun room. All bedrooms were sufficiently lit and had the required furniture. All smoke detectors and carbon monoxide detectors were observed to be functioning. No accessible bodies of water or hazards were observed. The facility had the required 7 days of non-perishables and 2 days of perishables. No food was expired. All fire extinguishers were observed to be fully charged. The facility was maintained at a comfortable temperature. Hot water was measured within the required 105-120 degrees. The facility's first aid kit was observed to have the required items.

All sharp objects, knives, detergent, and poisons were locked and in-accessible to persons in care.

LPA requested copies of the facility's job descriptions, theft and loss policy, transportation policy, and LIC 200 by 11/7/2025.

LPA Calandra reviewed Centrally Stored Medications Records(CSMR). A review of Centrally stored medications indicated that medications for residents were properly labeled with instructions on dosage and times of day and matched the Centrally Stored Medication Records(CSMR) kept at the facility.

No deficiencies were cited during today's visit.

An exit interview was conducted. This report was reviewed with facility representatives and a copy provided.