Facility Evaluation Report

On 09/09/2025, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA met with Licensee, Marinela Placintar and explained the purpose of the visit. The purpose of this visit was to conduct an annual visit. There were two staff members present, Christopher Nnam and Damian Campbell.

This facility is licensed to serve 6 residents of which all may be non-ambulatory. This facility has a hospice waiver for 4 and a dementia plan on file.

Current census is 4. A brief interview with Licensee Placintar was conducted.

A review of 4 resident files were conducted. 4 out 5 residents were obtaining hospice services from various hospice agencies. A review of 3 staff files were conducted. 3 out 3 staff files were complete and up to date.

The Facility Designated Administrator (FDA), Kenroy Anderson has an active certificate #7027437740 and expires on 01/02/2026.

A tour of the facility was conducted. The interior of the physical plant was in good condition and sanitary. Fire extinguishers appeared to have been annually inspected by Jorgenson Co on 07/16/2025.

The kitchen area was toured. LPAs observed a non-perishable and perishable foods in the cabinets and refrigerator. Additional food supplies were identified in the garage. LPA observed a locked centralized stored medication cabinet located in the kitchen. Along with the administrator, the LPA observed, reviewed, and compared resident medication and medication dispensing logs. First Aid Kit was present and contained all of the required components.

A tour of the bathrooms was conducted. Hot water temperature was measured and observed to be within the required range of 105-120 degrees. A linen closet was located in the hallway and presented a sufficient amount of linens to adequately supply and meet the needs of the residents at this time.

A tour of the bedrooms was conducted. Resident furniture was observed to be sufficient to meet their needs at this time.