Facility Evaluation Report

On 02/21/24, Licensing Program Analyst (LPA) L. Salazar arrived to the facility unannounced to conduct the required Annual Inspection Visit. LPA was greeted by Direct Support Personnel (DSP),stated the purpose of the visit and was allowed entry into the facility. DSP provided a tour of the facility inside and out while LPA waited for Administrator, who arrived to the facility shortly after LPA's arrival. Administrator on record is Ch, Certificate# 601610735, Exp. 05/24

LPA observed 1 resident in care at the time of visit, 2nd resident was in day program at the time if visit. Facility is a 2 bedroom 2 bathroom home. Residents bedrooms were observed to have the required lighting and furnishings and were free from odor and free from any passageway obstruction / fire hazards. Facility temperature was 69 degrees F.

Bathrooms were toured and observed to have operational lights, running water, and non- slip floors. Hot water temperature tested at 116 degrees F. Trash can with lid and hand washing postings were observed.

Medications were observed to be locked in an upper cabinet located in the dining area. Cleaning supplies were observed to be locked in the kitchen sink. LPA toured the kitchen observed the required 7-day supply of non-perishable food and 2- day supply of fresh perishables to be properly stored. There are no residents with Restricted Health conditions in the facility.

Carbon monoxide and smoke detectors were tested and observed to be operational. Night lights were observed in the hallways. Fire Extinguisher was observed with a service date of 05/12/23. First aid kit was observed and contained all required items. Internet devices and a working phone line were observed to be available for residents in care.