Facility Evaluation Report

On December 04, 2024, at 8:40 AM, Licensing Program Analyst (LPA) Kiran Jain arrived unannounced at the facility to conduct a Required 1-Year Annual inspection. LPA met with the Administrator, Jocelyn Perez and disclosed the purpose of the inspection. The administrator informed the LPA that the facility currently has 5 residents in care, 4f level, and 2 are non-ambulatory. Residents were away at their day program.

At 8:50 AM, the LPA initiated a walk-through of the facility, accompanied by the administrator.

At 8:50 AM, the LPA inspected the kitchen and found it clean, with no food preparation or cooking in progress at the time. LPA checked the appliances and observed them in working order. The locked cabinet containing knives and the locked cabinet under the sink with soap and cleaning supplies were also inspected. LPA inspected the refrigerator and pantry cabinets and observed enough supplies of fresh perishable food for (2) days and nonperishable staples for (7) days. No expired food and no stored medications were noticed.

At 8:56 AM, LPA inspected the family room, living room, and dining area and observed it clean, with all the furniture in good repair. There was a dining table and enough chairs to accommodate all the residents in the dining area, and a set of couches, chairs, and tables in the living and the family room.

At 9:04 AM, LPA inspected the fire extinguisher mounted on the wall in the living room and found it was fully charged with a last service tag of 01/28/2024. The administrator tested the smoke and carbon monoxide detector located in the hallway in the LPA's presence, and it was found to be functional. Additional smoke and carbon monoxide detectors were observed in all bedrooms and common areas of the facility during the visit.

There are (3) bedrooms and (2) bathroom designated for residents' use, and (2) bedrooms designated for staff. All resident rooms are shared occupancy. At 9:08 AM, LPA inspected all (3) resident rooms and found them clean, well-lit, and equipped with the required furniture.