Facility Evaluation Report

Licensing Program Analyst (LPA) Melisa Rankin arrived unannounced to conduct a one year required annual visit. The LPA met with Licensee/Administrator Carol Gantous and explained the reason for the visit.

LPA toured the physical plant areas inside and outside:

Physical Plant: The facility has a sufficient supply of non-perishable and perishable food items. Living and dining room furniture were observed to be in good condition. Smoke detectors and carbon monoxide detector were tested. The backyard has an area equipped with furniture for client use. No bodies of water noted. The washer and dryer are in the garage. The restroom was clean and sanitary and in operating condition. The bathroom was sufficiently stocked. The bedroom is furnished with appropriate linens and required furniture. Closets were observed with extra linens and towels.

Records: The LPA reviewed client and staff records. LPA reviewed client files with medical assessments with TB results, and needs and services plan were available. LPA reviewed one staff file for, but not limited to, the following: personnel records, health screening, criminal record statements, current first aid certification. Administrator certificate expires 1/14/28. The facility is vendored by Tri-Counties Regional Center (TCRC) as a level 2 home. The last disaster drill was conducted on 1/19/2026.

Medications : Medications are not centrally stored. Client is taking one medication which was labeled and checked for expiration date.

Resident participate in meal preparation and home upkeep, in support of their home functioning.

Exit interview conducted, a copy of the report was issued.