Facility Evaluation Report

On 08/01/2024 at 9:40 AM, Licensing Program Analyst (LPA) Ardalan Gharachorloo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Elizabeth Carson and explained the purpose of the visit.

LPA toured the facility including but not limited to 4 residents’ rooms, bathrooms, two activity rooms, kitchen, common area and courtyard. LPA observe lighting in all rooms are adequate for the comfort and safety of the residents. Hallway temperature was maintained at 70 degrees F. The hot water temperature in a residents’ shared bathroom was measured at 111.5 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medications, sharps and toxic are locked and inaccessible to residents in care.

Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 03/20/2024. Emergency Disaster Plan was last posted on 01/12/2024. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 06/13/2024.

At 11:34 AM, LPA reviewed 5 staff records and all were complete. At 12:30 PM, LPA reviewed 6 residents records, and all were complete. at 1 PM, LPA reviewed 6 residents medications.

LPA also reviewed and obtained a copy of the following documents: LIC 500 Personnel Report, LIC 610E Emergency Disaster Plan, Liability Insurance Current Administrator’s Certificate renewal documents.

No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.