Facility Evaluation Report

Licensing Program Analyst (LPA) Cuadra conducted an unannounced Annual Required Inspection and met with Licensee Nicholas Ray. There are three residents in care. Required postings were observed.

LPA/Licensee toured the facility and observed the following: Facility passageways were free of obstruction and comfortable temperature. Smoke detectors and carbon monoxide were tested and operational. Fire extinguishers were charged and serviced November 2025. Working auditory alarms are placed on all exits. Disinfectants and cleaning solutions were stored inaccessible to residents. Hygiene and linen supplies were available. The facility has supplies of non-perishable foods for a minimum of one week and perishable foods for a minimum of two days. Last disaster drill have been conducted within the last quarter (3/1/26). Hot water temperature measured at 109 and 118.6 degrees F which is within the range allowed per regulation.

LPA initiated file review at 9:30 am. LPA reviewed three residents files and three staff files. All residents have medical assessment and needs service plans are updated. All three staff have current First Aid/CPR certificates and 20 hours of additional required training. Administrator Certificate for Nicholas Ray, 7008284740, expired on 6/4/2025, LPA conducted a search into the Department's Administrator Certification Unit and was able to find Licensee's name is in the pending list as of 9/6/2025 waiting for processing. Medications and medication records were reviewed.

Licensee provided updates of the following: Personnel Report (LIC500) & copy of liability Certificate.

No deficiencies found during today's visit. Exit interview conducted with Licensee and copy of this report was given.