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 Tharanganie Mohottigue, Administrator. Wasantha Mohottige arrived at approximately 1:50 PM. LPA inspected the one-story facility for fire safety, personal accommodations, and food service.

There are currently five (5) residents residing in the facility. Currently, there is one resident on hospice, four (4) non-ambulatory residents and one (1) ambulatory resident. At the time of arrival, there was one (1) staff available in the facility, one Administrator, and five (5) residents present in the facility.

LPA toured the facility with Administrator. LPA observed five (5) resident bedrooms, and one (1) staff bedroom. Bedrooms #1, 2, and 4 are private rooms with private bathrooms. Bedrooms 3 and 5 are private bedrooms with a shared bathroom off the hallway.

Walls, floors, and doorways are clean with no safety hazards. The kitchen area consists of a countertop area, a refrigerator, a stove, a microwave, and a sink. Sharps and centrally stored medications are kept in a locked cabinet in the dining area with no access to residents. First aid kit was observed to be complete. Fire inspection was current as of 1/8/2025.

There is a sufficient amount of perishables for two (2) days and non-perishables for seven (7) days. Emergency food is stored in a second refrigerator and pantry located in the garage. There is a washing machine and a clothes dryer in the garage. Chemicals and toxic substances are kept in a locked cabinet in the garage.