Facility Evaluation Report

Licensing Program Analysts (LPA) Zabel Chochian arrived at this facility to conduct a required annual visit.

Upon arrival, LPA observed residents in the dining and common area. All required postings observed near the residents mail box area.

LPA met with the Executive Director (ED),Cynthia Drachenberg and reason for the visit was stated.

During the visit, LPA began the annual inspection with the following:

RECORDS REVIEW: Personnel records were requested for review. Beginning at approximately 11:30a.m. LPA reviewed ten (10) personnel records for, but not limited to job application, health assessments, TB results, criminal record clearances, first aid/CPR certification and required training. Staff files reviewed all had required records. Resident records were requested for review. At approximately 1p.m. LPA reviewed twelve (12) resident files for, but not limited to admissions agreements, medical assessment, updated appraisals, and personal rights. Two (2) out of the twelve resident files reviewed required updated medical assessments. ED stated that they will inquire and check their backlog filing for those identified missing records.

LPA reviewed facility's Infection Control Plan, Emergency and Disaster Plan at approximately 3:30pm. Due to time constraints, the LPA will return at a later date to continue the annual inspection.

No health and safety issues observed during today's visit. Exit interview held and copy of report provided.