Facility Evaluation Report

On June 17, 2025, Licensing Program Analyst (LPA) Komal Charitra conducted an unannounced annual visit. LPA met with Administrator, Phil Surdel and explained the purpose of the visit.

LPA toured the facility inside and outside including all of resident rooms, common areas & kitchen. The indoor and outdoor passageway was free of obstruction. No accessible bodies of water of fire safety hazards observed. This is a two story facility; communal area, laundry room, garage, one full bathroom and three private resident rooms on the first floor and two full bathrooms, kitchen room, dining room, living room, and two resident rooms; one of which is a private room and one shared room on the second floor.

All resident rooms were observed to be odor-free with all required furniture. All bathrooms were observed to be clean, equipped with liquid soap, paper-towels, and toilet paper. Non-skid mats were observed. Water temperature throughout the facility measured between 115-118 degrees F. Extra linen was observed to be present. First aid kit was observed to be complete.

Dining room was observed free from tripping hazards. A comfortable temperature is maintained and lighting is sufficient for comfort. LPA observed two day perishables and seven day non-perishables. Extra food supply was observed to be present. Medications, sharps, and chemicals were observed locked an inaccessible to residents in care.

Carbon monoxide monitors are working properly. All fire extinguishers have been checked and current as of

February 2025. Emergency drills are logged and done every three month. LPA reviewed 5 resident records and 5 staff records. Resident records are updated, complete and signed. Staff records are complete, with training logs that have met the basic requirement. Medication review was done, and all medications are accounted for, and centrally stored medication records are updated.

No citations are issued during the visit. Report is reviewed with Administrator and a copy is provided.