Facility Evaluation Report

On 04/26/23 at 11AM, Licensing Program Analyst (LPA) Daisy Panliliot arrived unannounced to conduct an Annual Required Inspection. LPA met with S1 and spoke to ADM on the phone who authorized S1 to act on his behalf and sign the reports. LPA explained the purpose of the visit with administrator (ADM, S1) and staff.

At 11:15AM, LPA inspected the facility including, but not limited to, living room, kitchen, dining area, bathrooms, bedrooms, laundry area and outside areas. Screening station was observed near the front entrance with visitors logs, no touch temperature probe, hand sanitizer and additional masks. The infection control leader is the administrator.

The facility has six (6) bedrooms and three (3) bathrooms. Two bedrooms and one bathroom are designated for staff use only. 2 day perishable and 7 day non perishable food supplies available. Facility maintained at 70 degrees, F. Hot water temperature in a client's bathroom measured at 110 deg F. Fire extinguisher was observed fully charged and last inspected 08/11/23, first aid kit complete, flashlights, smoke/carbon monoxide detectors operational. Emergency Disaster Plan dated 01/05/2023 posted near the kitchen. required posters centrally posted.

Exits and passageways were observed free of obstruction. Fire and Earthquake Disaster drills conducted monthly. There were no bodies of water present. LPA reviewed 5 client and 3staff files, P&I monies, medication and medication logs.

There were no deficiencies cited during inspection.

Exit interview conducted and a copy of this report provided.