Facility Evaluation Report

On 10/27/2022 at 11:45AM, Licensing Program Analyst (LPA) G. Luk conducted an unannounced Pre-licensing Inspection. LPA met with care staff, Irish Arenas. Administrator/ Applicant, Debbie Rieza arrived 30 minutes later.

LPA inspected the facility inside and out including but not limited to bedrooms, bathrooms, dining room, kitchen, living room, garage, and outdoor area. Facility has a 7-day non-perishable and 2-day perishable food supply. Medications were centrally stored in a locked closet. Home is clean and well ventilated with appropriate lighting. No bodies of water were observed. Indoor and outdoor passageways were free of obstruction.

Fire extinguisher was serviced on 5/6/2022. Smoke and carbon monoxide detectors were observed. First aid kit was complete.

The following will need to be completed before recommending licensure to Centralized Application Bureau (CAB) :

1. LPA observed screen door was broken and room 2's closet doors were off track.

2. LPA observed C4 has a full bed rail and C4 is not on hospice care. Administrator have contacted equipment company to obtain half bed rails for C4.

3. LPA measured hot water at 138.8 degrees F in the hallway bathroom sink.

Administrator/ applicant will submit proof of corrections to CCLD on/before 11/4/2022.

Exit interview conducted with Debbie Rieza and a copy of this report provided.