Facility Evaluation Report

Licensing Program Analyst (LPA) Brian Balisi arrived at the facility unannounced to conduct a required annual visit. Upon arrival, the LPA met with staff and explained the reason for the visit. Administrator Maria Karina Antig arrived shortly after. LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and the facility is in compliance with Title 22 Regulations.

At approx 10:00 a.m. LPA inspected the kitchen/food service area. Knives and sharp objects are stored in a locked cabinet underneath the sink. No cleaning supplies were observed kept underneath the sink. Kitchen appliances were observed to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food properly stored at this time. LPA observed medication centrally stored and resident files securely stored in this in a cabinet in front of fridge.

At the time of the visit, the common area furniture's were observed to be in good condition. A sufficient supply of clean linen and towels were observed stored in the hallways cabinets. A sufficient supply of PPE and toiletries were observed stored inaccessible to residents in care in a hallway cabinet. The facility maintained a comfortable temperature of 72 degrees Fahrenheit. Smoke detector(s) and carbon monoxide detector were operational at the time of the visit. LPA observed fire extinguishers to be fully charged and purchased in Jan, 20 2026. LPA observed six (6) bedrooms total. One (1) bedroom is designated for staff use. Resident bedrooms were observed furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are two (2) bathrooms, they were observed to be clean and sanitary and in operating condition with grab bars and non-skid surfaces. The bathrooms were sufficiently stocked with supplies and paper towels. The hot water temperature was measured between 105 - 120 degrees Fahrenheit. LPA observed staff room to be inaccessible to residents in care and empty at this time. At approx 10:30 a.m. LPA's records review of facility sketch revealed Bedrooms #5 and #6 were not notated on the original LIC 999 on file.