Facility Evaluation Report

Licensing Program Analyst (LPA) Victoria Brown arrived unannounced to conduct a Required - 1 Year visit on 6/13/24 at 10:00am. LPA observed the Administrator Certificate expires on 10/06/2024 for Chukwudi Ikiseh.

LPA met with Marie Longmore, and Sophia Brown, Caregiver(s) and stated the purpose of todays visit. LPA spoke with Administrator Chukwudi Ikiseh regarding todays visit. Shadae James, Designee arrived within 15 minutes to assist with todays visit. The most recent emergency drill was conducted on 5/14/24.

The facility is licensed for a capacity of 6 residents of which 1 may be bedridden in room 1. Hospice waiver approved for 2 to receive hospice care services. There is 2 residents receiving hospice care services during this visit.

LPA toured and inspected the physical plant inside and outside to ensure there are no safety hazards to residents. LPA observed 2-day perishables and 7-day non-perishables.

The temperature inside the facility was observed to be at 76*F which is within the required range of 68-85*F. The hot water temperature was measured at 111.6*F which is within the required range of 105-120*F. LPA observed fire extinguisher(s), smoke and carbon monoxide detectors, and central heating and air in the facility. LPA observed the centrally stored medications area to be locked and inaccessible to residents.

The first aid kit contained the required items such as sterile dressings, bandages, adhesive tape, scissors, tweezers, thermometers, antiseptic solution and guide.

LPA reviewed 2 staff and 2 resident files and conducted interviews during this visit.