Facility Evaluation Report

On 07/24/2025, Licensing Program Analyst (LPA) Triel Ellen Lindstrom arrived unannounced at the facility to conduct a required annual inspection. The LPA met with Designated Facility Administrator (DFA) Alexis Alvarez. The LPA introduced herself, explained the purpose of the visit, and conducted an interview with the Administrator. The DFA accompanied the LPA on a tour of the facility.

The facility is a one story building that is licensed for forty-five residents. The facility had a hospice waiver for five. The census was thirty-five at the time of this inspection.

The LPA toured the common areas, including gathering areas, dining rooms, and hallways. These areas were clean, uncluttered, decorated, and bright with natural light. The LPA observed that these areas were pest-free and odor-free. There was enough furniture to accommodate all residents for dining, as well as for spending time with visitors.

The LPA toured the kitchen and interviewed the new Culinary Services Manager. Kitchen staff do a deep clean monthly. The kitchen was clean and free of grease, food debris, and spills. The facility had a seven day nonperishable and two day perishable supply of food. Staff took the temperature of food and drink for every meal and every day of the week to ensure food safety. Temperatures of refrigerators and freezer interiors were also logged daily and the ambient temperature monitored. The stove hood was last serviced on May 25, 2025 by AFS Fire1.

The LPA observed resident bedrooms and bathrooms. The bedrooms were clean and had the required furniture in it. The bathrooms were also clean, odor-free, and had non-slip mats, grab bars, and modifications as needed to accommodate the rooms' residents. The LPA measured the temperature of the