Routine inspection·April 18, 2024

Licensing Program Analyst (LPA) Debbie Correia made an unannounced visit to the facility to conduct an annual licensing inspection. LPA identified herself to Caregiver Duclayan and explained the purpose of the visit. The facility is licensed to six (6) residents of whom five (5) must be ambulatory, one bed-ridden (1), and 5 receiving hospice services. During today’s visit, LPA Correia conducted a partial interior tour of the facility and resident records reviews. LPA also briefly spoke to a resident in care and interviewed facility staff. An overall inspection of the facility began today. However, due to time constraints LPA was unable to complete the visit and will return later time to conduct the remaining portion of this inspection. No deficiencies were cited during today's visit. This report was discussed with Caregiver Duclayan. A copy of the report and License Rights (01/2016) will be provided at the conclusion of the visit, and signature on this form acknowledges receipt of the rights and a copy of this report.