Facility Evaluation Report

On 12/12/23 Licensing Program Analyst (LPA) M. Garza arrived unannounced for an annual inspection visit. LPA contacted Administrator, Veronica Matthew. LPA introduced self, explained reason for visit and was informed it would take some time to arrive. LPA was met by Administrator some time later and was permitted entry into the facility.

LPA completed a health and safety check on residents in care. LPA was informed by Administrator residents were at day program during time of visit. LPA toured the facility inside and out. Pathways and doors were clear and free from obstruction. Facility was tidy. Common areas were clean, adequately furnished, and adequately lit. 1 smoke detector was present and operational at time of visit. Fire extinguisher last purchased 8/16/23 and okay. Last fire drill on 11/20/23. Water temperature measured 119.8 degrees F. Resident rooms observed to have the required furnishings and with adequate lighting. Linen supplies are kept in linen closets. Sharps, chemicals and medications were located in locked inside kitchen cupboards.

During visits the following issues were observed: A smell of gas was observed upon entry to the facility. Smoke detectors not observed in all common areas. No carbon monoxide detector present during time of visit. Facility has physical plant issues that will need to be addressed. Facility is a historic home and will be pending city contact. .

LPA requested the following documents to be submitted to CCL by 12/19/23: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-E), Affidavit regarding Resident Cash Resources (LIC 400), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) in order to update the facility file.

Due to time constraints, LPA will return at a later date for an annual continuation. Exit interview completed with Administrator, Veronica Matthew. A copy of this report was given.