Crestwood Villa II

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a required annual visit. LPA met with administrator Raimonda Banakiene and explained the reason for the visit. Beginning at 11:28 a.m., LPA conducted a tour of the physical plant with the Administrator. The following was noted: Facility is a single-story residence that consists of six (6) resident bedrooms and two (2) bathrooms. The LPA observed (1) fully charged fire extinguisher that was purchased on 01/18/2026. Hardwired smoke alarms and carbon monoxide detectors were tested at 01:28 p.m. and functioned properly. Bedrooms: The resident bedrooms were properly furnished with a chair, nightstand, and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets. Bathrooms: LPA observed all bathrooms clean, properly supplied and had functional fixtures. The LPA observed grab bars and slip resistant surfaces in all bathrooms. Residents have sufficient amounts of supplies for personal hygiene. Hot water temperature was measured and was within the required range. Kitchen: The kitchen appeared clean and the appliances and fixtures functional. LPA observed a sufficient amount of perishable and non-perishable food at the facility. Knives are stored in the locked medication closet near the front entry. Common Areas: These included a living room, family room, and dining area. These areas were properly furnished and functional for residents. The facility maintained a comfortable temperature. There is a hall closet which contained linens and hygiene supplies. Required postings were observed in the common area. (Continued on LIC809-C) Garage: The locked garage had a washer and dryer, cleaning supplies, PPE, and some additional food. Surrounding Grounds (Outdoors): There was a shaded area with proper furniture for outdoor use. There are no bodies of water on the premises. All passageways were observed to be clear. File review: Beginning at 11:50 a.m., LPA reviewed all six (6) residents' files; all files were complete. LPA reviewed five (5) staff files and the administrator's file. All staff are fingerprint cleared and associated to the facility. All staff have their health screenings, training and other personnel records. Infection Control and Emergency Disaster Plan: LPA reviewed the facility's infection control practices and the facility's emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster drills are conducted quarterly with all staff, with the last documented drill on 12/03/2025. Emergency disaster plan was observed to be complete. Medications: Medications are stored locked in an entry way closet. LPA reviewed the centrally stored medication and destruction records (CSMDR) beginning at 02:15 p.m. LPA reviewed medications which were properly documented on the CSMDR and appear to be given as prescribed. No deficiencies observed. Exit interview conducted and copy of the report provided to Administrator.the state’s words, verbatim · CDSS document, Mar 11, 2026

The state marks this report as 5 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Teresa Camara arrived at the facility unannounced to conduct a required annual visit. LPA met with administrator Raimonda Banakiene and explained the reason for the visit. LPA conducted a tour of the physical plant with the Administrator. The following was noted: Facility is a single-story residence that consists of six (6) resident bedrooms and two (2) bathrooms. The LPA observed (1) fully charged fire extinguisher that was purchased on 3/4/2024. All smoke alarms and carbon monoxide detectors were tested at 11:52 a.m. and functioned properly. The facility serves residents with dementia, the auditory alarms on the exit doors were tested and functioned properly. Kitchen: The kitchen appeared clean and the appliances and fixtures functional. LPA observed a sufficient amount of perishable and non-perishable food at the facility. Knives are stored in the locked medication closet near the front entry. Bedrooms: The resident bedrooms were properly furnished with a chair, nightstand, and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets. Bathrooms: LPA observed all bathrooms clean, properly supplied and had functional fixtures. The LPA observed grab bars and non-skid mats in all bathrooms. Residents have sufficient amounts of supplies for personal hygiene. Hot water temperature was 115 degrees Fahrenheit. (Continued on LIC809-C) (continued from LIC809) Common Areas: These included a living room, family room, and dining area. These areas were properly furnished and functional for residents. The facility maintained a comfortable temperature. There is a hall closet which contained linens and hygiene supplies. Garage: The locked garage had a washer and dryer, cleaning supplies, PPE, and some additional food. Surrounding Grounds (Outdoors): There was a shaded area with proper furniture for outdoor use. There are no bodies of water on the premises. Medications: LPA reviewed the centrally stored medication and destruction records (CSMDR). LPA reviewed medications which were properly documented on the CSMDR and appear to be given as prescribed. Interviews: LPA spoke with two residents who were happy with the facility staff, cleanliness, care, and food. They had no concerns. LPA spoke with staff as well; there were no concerns. File review: LPA reviewed all six (6) residents' files; all files were complete. LPA reviewed five (5) staff files and the administrator's file. All staff are fingerprint cleared and associated to the facility. All staff have their health screenings, training and other personnel records. Infection Control and Emergency Disaster Plan: LPA reviewed the facility's infection control practices and the facility's emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster drills will be conducted quarterly with all staff. Emergency disaster plan was observed to be complete. No deficiencies observed. Exit interview conducted and copy of the report provided to Administrator.the state’s words, verbatim · CDSS document, Mar 5, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Esther Cortez arrived at the facility unannounced to conduct a required annual visit at 01:45 p.m. The LPA met with administrator Raimonda Banakiene and informed them of the reason for the visit. At 01:52 p.m. the LPA conducted a tour of the physical plant with Administrator Raimonda. The following was noted: Facility is a single-story residence that consists of six (6) resident bedrooms and two (2) bathrooms. The LPA observed (1) fully charged fire extinguisher that was purchased on March 04, 2024. All smoke alarms and carbon monoxide detectors were tested and functioned properly during time of visit. The facility serves residents with dementia, the auditory alarms on the exit doors were tested and functioned properly. Kitchen: The kitchen appeared clean and the appliances and fixtures functional. The LPA observed a sufficient amount of perishable and non-perishable food at the facility; Sharp objects are stored in a locked closet. Bedrooms: The resident bedrooms were properly furnished with at least one chair, nightstand, and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets. Bathrooms: LPA observed all bathrooms clean, properly supplied and had functional fixtures. The LPA observed grab bars and non-skid mats in all bathrooms. Residents have sufficient amounts of supplies for personal hygiene. At 02:14 p.m. water temperature in resident’s restroom was measured at 110.4 degrees Fahrenheit. Report will continue on LIC809-C. Common Areas: These included the living rooms and dining area. The common areas were checked for cleanliness and furniture was checked for functionality during time of visit. The facility maintained a comfortable temperature of 72 degrees. Garage: The garage is where the washer and dryer are held. Cleaning supplies and disinfectants are kept in the garage. The garage is locked. Surrounding Grounds (Outdoors): There was a shaded area with proper furniture for outdoor use. There are no bodies of water on the premises. Medication audit: Medications review began at 02:25 p.m. The LPA conducted medication audit for three (3) of six (6) residents. Medications are centrally stored and locked in a closet; medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medications and destruction record. Interviews: The LPA conducted one (1) resident interview and attempted to interview a second resident. No immediate concerns voiced during the visit. File review: At 02:56 p.m. a review of facility files was initiated. The LPA reviewed two (2) of six (6) resident files. Out of the two files reviewed, the LPA identified that one resident (R1) requires an updated physician’s report, due to the diagnosis of dementia. Due to time constraints the LPA will return to complete the annual at a later date. Exit interview conducted and copy of the report and appeal rights provided to Administrator.the state’s words, verbatim · CDSS document, Mar 21, 2024