Facility Evaluation Report

On 05/12/2026, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA Pascua met with Facility Designated Administrator (FDA), Marinela Placintar and explained the purpose of the visit.

Current census was 6. A brief interview with FDA Placintar was conducted.

This facility is licensed to served 6 residents, all of whom may be non-ambulatory. This facility has a hospice waiver for 2 and has a dementia plan on file.

LPA Pascua reviewed 5 resident files and 3 staff files. All files were complete and up to date. FDA Placintar has an active administrator certificate

LPA Pascua initiated a tour of the facility with Licensee Placintar.

The interior of the physical plant was in good condition and sanitary. Fire extinguishers appeared to have been annually inspected by Jorgenson Co and is valid until 02/26/2023..

The kitchen area was toured. LPA observed a non-perishable and perishable foods in the cabinets and refrigerator. Additional perishable 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.

Laundry area was toured. Laundry detergent, bleach, and all other cleaning supplies were observed to be locked and made inaccessible to the residents at this time.