Facility Evaluation Report

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

The facility is licensed to serve adults age 60 and over and approved for capacity of 6, 5 may be non-ambulatory and 1 ambulatory and approved for 2 hospice waiver.

LPA toured the facility, including common areas, resident rooms, kitchen, bathrooms, driveway, and outdoor spaces and storage areas.

The kitchen was sanitary and organized; knives and chemicals were locked. Food supply met requirements (2 days perishable, 7 days non-perishable). Bathrooms had grab bars and non-skid mats. Resident rooms had adequate storage for personal belongings. Medications were locked and inaccessible to residents; first aid kit was complete. Outdoor areas were free of hazards; laundry appliances were functional, and cleaning supplies were secured. LPA observed fire, smoke, and carbon monoxide alarm systems were operational; indoor hallways were clear and well-lit. The facility's ramp at the back is sturdy and in good condition. The exit doors are free from tripping hazard and free from obstruction.

Indoor temperature was within acceptable range of 65°F. Kitchen water temperature measured at 111.9 up to 112.1°F. 2 out of 2 bathroom hot water temperature was measured and range from 113.1°F to 114.9°F.

Refrigerator temperature is at 32°F and freezer temperature is at 0°F.