Facility Evaluation Report

Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced required annual inspection to the above-named facility. Upon arrival, LPA was greeted by Staff 1 (S1). Administrator John Urquiola arrived at approximately 2:00 PM. At the time of arrival, there were 5 residents in care and 1 staff on duty.

LPA explained the purpose of the visit. The facility is a Residential Care Facility for the Elderly (RCFE) and is home to non-ambulatory residents with a dementia diagnosis. There is one resident currently on hospice.

A tour of the physical environment and accommodations were assessed, and the following was noted: LPA observed the required posting of the complaint poster, Resident’s Personal Rights, and Long Term Care Ombudsman poster. LPA inspected the one-story facility for fire safety, personal accommodations, and food service. First aid kit was observed to be complete.

The physical environment was checked for cleanliness and condition. Walls, windows, ceilings, doors, floors and floor coverings were checked. The facility was seen to be in good repair i detectors/smoke alarms throughout the facility all in good working order.

The kitchen area was sufficiently stocked with two-day perishables and seven days inside and outside. Fire inspection was most recently conducted on 6/25/2025. There are eleven (11) dual carbon monoxide and smoke alarms. All are in good working order.

LPA observed a sufficient amount of perishable foods for 2 days and non-perishables for 7 days. Snacks and beverages are readily available for Residents. LPA observed the kitchen cabinets, refrigerator, stove, and counters are clean.

Medications are stored in a locked cabinet located in the dining area. At approximately 2:44 pm, Medication inventory revealed the following: Resident 1’s (R1’s) prescribed Tamsulosin HCL 0.4 MG capsule count had one extra tablet. Resident 2’s (R2’s) prescribed Trazodone 50 MG tablet count had two extra tablets. Please continue to 809-C, Pg 2.