Facility Evaluation Report

On 04/04/2025, Licensing Program Analysts (LPAs) Arielle Pascua and Triel Lindstrom arrived unannounced to this facility to conduct an annual visit. LPAs met with Staff members (SM), Nicollete Groves and Sharion Lamison and explained the purpose of the visit. LPAs asked that SM Groves call the Facility Designated Administrator (FDA), Ana Guerrero that CCL was present at this time. Shortly after, LPAs met with FDA Guerrero.

Current census was 6. A brief interview with FDA Guerrero was conducted. This facility is licensed to serve and retain 6 elderly residents whom of which all may be non-ambulatory. This facility also has a hospice waiver for 4 residents at this time.

LPA Pascua toured the grounds and observed them to be well maintained. All paths were free of obstruction. LPA Pascua toured the physical plant. The facility is a single story building with 4 bedrooms.

There are 2 double occupancy rooms and 2 single occupancy rooms. The facility was observed to be sanitary and free of odor. There was adequate furnishings and lighting throughout. The facility maintains an adequate supply of linens. All furniture was observed to be in good repair.

LPA Pascua inspected the kitchen and observed all knives to be locked and inaccessible to residents in care. There was in excess of a 2 day supply of perishable food and a 7 day supply of non-perishable food. Food in the refrigerator was labeled with the date opened. There was no expired food product observed. Lunch service was provided during the course of this inspection and residents received different lunches according to each individual's preference. There was fresh fruit and vegetables available.