Facility Evaluation Report

Licensing Program Analyst (LPA) Tihesha “Lynn” Smith conducted an unannounced annual/infection control visit to this facility at 12:07 pm and observed COVID signs on the front door. LPA was greeted by caregiver Rita Avetikyan and temperature was taken and recorded. The administrator was called at 12:10 and arrived later.

LPA reviewed files for staff and clients between 12:35 pm -1:20 pm. Client files were reviewed and observed to be complete and current at time of visit. Staff files included current first aid and CPR certifications as well as sufficient training documentation.

LPA conducted a tour of the physical plant between 1:20-2:40 PM to ensure there are no health and

safety hazards and facility staff are following Title 22 Regulations.

LPA was escorted to the living area. The living area had furnishings and sufficient lighting and observed to be clean with adequate seating for clients. LPA was escorted to kitchen/dining combination area. The area was clean and well kept. The kitchen food supply was observed and sufficient for the four (4) clients currently residing there. Two (2) days of perishable fruits, vegetables, milk, and eggs observed. The freezer is stocked with meats, poultry, and frozen vegetables. There is a supply of canned foods, dried foods, and water in a side storage area off kitchen back door.

Sharps and cleaning supplies are locked in cabinet under kitchen sink. The medications and fully stocked first aid kit are locked in kitchen island cabinet. Medication observed to be properly labeled. Client medications and records reviewed and consistent with the centrally stored medication log.

The laundry room located to the left of hallway observed to be clean and appliances in good repair. Two (2) locked cabinets above washer and dryer store toiletry/hygiene back stock and laundry detergents. There is a sufficient supply of linens and PPEs in laundry room pantry.