Facility Evaluation Report

Licensing Program Analyst (LPA) Maria Partoza conducted an unannounced annual inspection and met with the Designated Administrator (DADM) Philipp Perez and stated the purpose of the visit.

The facility is licensed to serve adults age 60 and over, 6 ambulatory of which 6 may be non-ambulatory and hospice waiver for 6. LPA observed 2 staff and 6 residents. Residents were in their respective rooms and resting at the time of the visit. 4 out of 6 was asleep and 1 out of 6 refused to be interviewed, and 1 out of 6 was outside smoking.

LPA toured the facility, including common areas, resident rooms, kitchen, bathrooms, garage, and outdoor spaces. The kitchen was clean and organized; knives and chemicals were locked. Food supply met requirements (2 days perishable, 7 days non-perishable). Medications were locked and inaccessible to residents; first aid kit was complete. Fire, smoke, and carbon monoxide systems were operational; hallways were clear and well-lit. Kitchen and bathroom water temperature measured at 118.2°F. Bathrooms had grab bars and non-skid mats; resident rooms had adequate storage. Fire, smoke, and carbon monoxide systems were operational; hallways were clear and well-lit. The facility has room temperature of 84 degrees F. The facility is equipped with a fire extinguisher that was last inspected on 08/12/2025. Outdoor areas were free of hazards; laundry appliances were functional, and cleaning supplies were secured. LPA observed roaches inside one of the condiment cabinets. DADM stated that the fumigation process is ongoing and one is scheduled for 6/3/2026.