Facility Evaluation Report

Licensing Program Analyst (LPA) Christian Gutierrez conducted the annual inspection using the Compliance and Regulatory Enforcement (CARE) tools. LPA met with Caregiver Kevin Brewer and explained reason for visit. Administrator Louise Brewer was notified by telephone.

Facility is a Residential Care Facilities for the Elderly (RCFE) and is licensed to serve adults ages 60 and over. Six (6) total bed capacity (including 2 non-ambulatory) bedrooms # 2 and 4 approved for one (1) ambulatory each. Waiver granted for four (4) hospice care. Facility is a single-story home located in a residential area consisting of four (4) bedrooms, two (2) bathrooms, kitchen, dining room, living room, family room, attached garage, and backyard with seating and shade.

LPA toured the facility and observed the following: Each resident bedroom has the required furniture and bedding. The Smoke detectors were observed throughout the facility and are properly operating. There is one carbon monoxide detector in hallway. The facility has one (1) fully charged fire extinguisher which is kept in family room. Cleaning supplies and toxic substances were observed to be accessible to residents from unlocked kitchen door leading to attached garage cleaning supplies on floor. Freezers are maintained at a temperature of 0-degree F and the refrigerators at a maximum of 40 degrees F. LPA observed medication in refrigerator to be unlocked in medication box. Facility was observed to have sufficient supply of 2 days perishable & 7 days non-perishable foods. There are no firearms or weapons stored at the facility. The hot water temperature in the bathrooms were measured between the required range of 105-120 degrees F. The resident bathrooms have the required grabs bars and non-skid mats. During tour of facility LPA observed medication closet in hallway to be unlocked. The facility does not have a swimming pool or bodies of water on the premises There is a shaded seating area for the residents in back yard. Passageways and exits are free of obstruction.

LPA reviewed residential infection control plan 9282, and emergency disaster plan 610E at time of visit. Last drill conducted was on May 10 th , 2025. LPA reviewed two (2) resident medications and both had missing medications.

***Due to time constraints, LPA was not able to complete the annual inspection for this facility. LPA will do a continuation of this inspection. ***. Deficiencies have been noted on LIC 809D under Title 22 Regulations. Exit interview was conducted and a copy of this report, LIC 809D and appeal rights were provided.