Facility Evaluation Report

Licensing Program Analyst (LPA) Valeria Conway arrived at the facility unannounced to conduct a required annual visit at 9:00 A.M. The LPA met with Facility Designee, Virginia Farin, and explained the reason for the visit. Administrator on file, Arlene Martinez, was contacted via telephone. Administrator was unavailable during today's visit, but authorized Facility Designee, Virginia Farin, to sign today's reports. Entrance interview conducted.

Beginning at 11:15 A.M., the LPA, along with Facility Designee, toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed:

Facility is a two-story residence, the upstairs area is inaccessible to residents in care and is used for staff only, therefore it was not observed. Fire extinguisher was fully charged with purchase date of 06/01/2026. Hardwired smoke and carbon monoxide detectors were tested at 12:15 P.M. and all were functional at the time of the visit. LPA observed exit alarms by all doors which were functional during the visit.

BEDROOMS: There are four (4) total resident bedrooms in the facility; two (2) are designated as private resident rooms and 2 (two) are designated as shared rooms. All residents’ rooms are set up with beds, nightstands, lamps, chests of drawers, chairs and closet space. The bedrooms were large enough to allow for easy passage. Bedridden bedroom #1 and bedroom #4 have exits to the exterior and attached bathrooms. LPA observed that facility is retaining bedridden residents in a room which is designated as non-ambulatory. Additionally, one resident was using supplemental oxygen; however, "No Smoking – Oxygen in Use" signage was not present in areas where oxygen was in use. Technical Violation (TV) issued.