Facility Evaluation Report

On 06/27/2023 at 11:10 AM, Licensing Program Analyst (LPA) L. Alexander arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Obed D'Autruche and explained the purpose of the visit. The facility’s fire clearance was approved for 4 Non-Ambulatory.

LPA toured facility with Obed including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 5 total bedrooms which 2 shared bedrooms are occupied by the residents and 3 bedrooms is occupied by staff. All outdoor and indoor passageways are kept free of obstruction except for side entry gate. There are no bodies of water observed. A comfortable temperature is maintained at 73 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 130.6 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 medication and sharps were locked and inaccessible to residents.

Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 04/04/2023. Emergency Disaster Plan was last posted on 02/08/2018. First aid kit was observed to be complete. Emergency disaster drill have not been conducted.

LPA reviewed 3 residents records. LPA reviewed 7 staff records and 1 of 7 have current first aid training and associated to the facility. LPA reviewed a sample of resident’s medications and it matched Medication Administration Record for R2.