Facility Evaluation Report

Licensing Program Analyst (LPA) Zabel Chochian arrived at the facility today to conduct a required annual visit. Upon arrival LPA was greeted by Staff/Caregiver Ana Leyva. LPA introduced self. Caregiver contacted the Assistant Administrator Connie Roush by phone and was informed of the LPA's visit. Assistant Administrator arrived to the facility shortly after LPA.

At approximately 11a.m., the LPA met with and interviewed three (3) residents. A physical plant tour was conducted with caregiver Ana Marie Leyva at approximately 11:45 a.m.. Facility is a single-story residence that consists of five (5) resident bedrooms and four (4) bathrooms. There is one (1) additional bedroom for staff use. The facility serves residents with dementia, the auditory alarms on the exit doors were tested and functioned properly at the time of visit. Kitchen : The kitchen appeared clean and the appliances and fixtures functional during the time of visit. LPA observed a sufficient amount of perishable and non-perishable food at the facility; Sharp objects are stored in a locked cabinet to the left of the dishwasher. At 12:30 p.m. hot water measured at 115.2 degrees Fahrenheit. Bedrooms: All resident’s bedrooms were properly furnished with at least one chair, a bed, night stand, chests of drawers, and sufficient lighting for each residents. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets. The bedrooms were large enough to allow for easy passage between the beds and furniture. In addition, no bedroom was used as a passageway to another room, bath, or toilet. All rooms were free of odors. All window screens were clean and maintained in good repair. Bathrooms: LPA observed all bathrooms were clean, properly supplied and had functional fixtures. The LPA observed grab bars and non-skid mats in all bathrooms. Residents have sufficient amounts of supplies for personal hygiene. Hot water was measured in two (2) bathrooms and observed within the required limit of 105-120 degrees Fahrenheit (116*5-118.6*f). Continue to LIC809c..