Facility Evaluation Report

On 04/28/23, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an Annual Inspection. LPA greeted by Supervisor (S1) Walter Rios and was granted entry into the facility. Temperature checked and visitor log was observed upon arrival. LPA introduced self and stated the purpose of the visit. Licensee (L1) Sheila Bagsby was called and arrived shortly. LPA conducted tour with L1 and S1. All six clients were present when inspection began. Three clients left to appointment later during inspection.

The tour started in the common areas, into the kitchen and to resident's rooms.

LPA observed COVID-19 related signs. The facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside. Facility was observed at temperature 71 degree F. Fire extinguisher was observed with a service date of: 01/10/23. Fire drill last completed 04/20/23.

An adequate supply of perishable and non-perishable food was observed. Refrigerator temperature maintained at 40 degrees F and freezer temperature at 0-degree F. Cleaning supplies and chemicals are kept in locked under kitchen sink and hall closet.LPA observed 2 shared residents’ bed to be at least 6 feet apart and 2 single occupant rooms.

Clients' bedrooms were toured and observed to be adequately furnished with bed, dresser, and adequate lighting. Bathrooms were properly equipped. Hot water temperature was tested at 105 degrees F and range at 105.1 and 105.3 in shared bathroom.Trash can with lid and hand washing postings was observed.

Outside of facility toured. Side gate was self-closing and self-latching. Carbon monoxide and smoke detectors were tested and observed to be operational. LPA observed medications locked in medication cabinet in the common area.