Facility Evaluation Report

On 4/21/2023 starting at 9:25 AM, Licensing Program Analyst (LPA) L. Fici arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with JOE, ISABELLA- Licensee and explained the purpose of the visit. The licensee administrators certificate is valid and expires on 11/28/2023. The facility’s fire clearance was approved for all four (4) ambulatory residents, two (2) non- ambulatory residents and two (2) hospice waivers. Upon entry, LPA observed two (2) staff and five (5) residents present during inspection.

Starting at 10:20 AM, LPA toured facility with licensee including but not limited to four (4) bedrooms, three (3) bathrooms, kitchen, common area and backyard. The facility consists of 4 total bedrooms which 1 bedroom is private, and 3 bedrooms are shared. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 68 Degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents'. The hot water temperature in residents’ common area bathroom was measured at 107.6 Degrees Fahrenheit. Residents’ bathrooms are equipped non-skid mats. There is a minimum of one-week supply of nonperishable and 2-day supply of perishable foods. Sharps and toxins were locked and inaccessible to residents'.

Smoke detectors and carbon monoxide detector were in operating condition. Fire extinguisher was observed last serviced on 3/4/2023. First aid kit was observed to be complete.