Facility Evaluation Report

Licensing Program Analyst (LPA) Melisa Rankin arrived at 09:15 am to conduct a 1-year annual visit. LPA met with Leilanie Acosta Vea and explained the purpose of the visit.

A tour of the inside and outside of the facility was conducted with Administrator . The following was inspected and noted during the annual visit:

Physical Plant & Environment Safety: The facility is a 6 bedroom and 3 bathrooms, one of which is being used as an office and another which is located on the fire clearance as a “Manager room” in the garage. The facility is occupying five (5) residents and employs two (2) staff of which one is the Administrator and two (2) back-up staff. The facility is clean, safe and sanitary. LPA was authorized to enter and inspect facility. The facility has smoke and carbon monoxide detectors which were tested and working properly at time of inspection. The lighting and lamps are sufficient for the use of the facility and for resident comfort. The showers have non-skid mats/non-skid flooring. Toilet, hand washing and bathing facilities are operational and secured grab bars are present. The pathways are clear of any obstructions. Facility is well lit inside and outside for safety. Disinfectant, cleaning solutions and poisons are inaccessible to residents. The facility has sufficient space inside and outside for activities and visiting. The facility has a backyard for client use with furniture and plenty of shade. The backyard has 2 sheds which are secured. The facility has telephone and internet service for resident use.

Operational Requirements: The Facility is operating in compliance with the granted fire clearance and facility sketch. The facility has current liability insurance which expires on 05/17/2026. The facility is approved for a capacity of 5 non-ambulatory and approved for hospice waiver of 1.