Facility Evaluation Report

On 8/13/2024, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required inspection. LPA introduced self, stated purpose of visit and allowed entrance by caregiver. Licensee/Administrator, Kevin Allison contacted by telephone and arrived a short time later to conduct facility inspection with LPA.

Currently there are three (3) residents in placement. Two residents were present at time of inspection, residents observed to be seating at dining room table preparing for breakfast at time of arrival.

Facility tour conducted. Facility observed to be well lit, and a comfortable temperature. Facility has 3 private bedrooms, resident bedrooms observed to have required furnishings. LPA observed R1 bedroom walls to have damage and in need of repair. LPA observed carpet throughout facility in need of cleaning. Air vent and filter in hallway is in need of cleaning and or replacement. Resident bathrooms toured, fixtures observed to be operational during inspection, water temperature measured at 112 degrees F. Both living room and dining room observed to have adequate seating for residents. Kitchen toured, LPA observed a 2-day supply of perishable and a 7-day supply of non-perishable food available for residents. All knives are locked and secured in kitchen drawer. LPA observed kitchen island to have broken and missing tiles. Medications observed to be locked and secured in kitchen cabinet. LPA observed medications to have original labels, and to be administered as prescribed.

All cleaning supplies observed to be locked and secured under kitchen sink. Fire extinguisher present with a purchase date of 5/22/2024. Smoke detectors and carbon monoxide detectors present and observed operational on date of inspection.