Facility Evaluation Report

On 11/05/2025 at approximately 09:20AM, Licensing Program Analyst (LPA) Ali Deniz arrived unannounced to conduct 1-Year Required visit of this licensed Residential Care Facility for The Elderly (RCFE). LPA was greeted by Administrator, Danica Ednalaga. The facility currently approved for capacity of 4 residents and has an approved fire clearance for 4 non-ambulatory residents. Facility has an approved hospice waiver for 2 individuals. Upon arrival, LPA was informed that there were 4 residents in care and 4 staff members on-site. Facility is a 1 story building with 4 Resident bedrooms, 2 bathrooms, and common spaces.

At approximately 09:45AM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation.

At approximately 10:05AM, LPA and Administrator toured the building and grounds which was found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed. All notices that are required to be posted have been posted and are in a highly visible area. LPA observed activity supplies for resident use. The amount of fresh and nonperishable foods is within regulation. Facility kitchen, refrigerators and freezers were clean, and food was stored properly. Toxins are stored in a locked housekeeping closet in the laundry room and under the sink. Water temperature measured 118.9 degrees F and 112.4 degrees F which is within regulation between 105- and 120-degrees F at faucets accessible to residents. Facility has emergency generator for any power outage.

Fire Extinguishers found to be last charged on 07/25/2025 at the time of visit. Carbon Monoxide and smoke detectors were present and in order. There was enough lighting in all common areas, resident rooms, and hallways. Medication is centrally stored and secure in a medication cabinet next to the dining room.