Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced Annual Required Visit on 07/15/2023 at 9:25am. LPA was met by Staff #1 (S1) and explained the purpose of the visit. Facility is licensed to serve residents over 60 years old. The facility cares for elderly residents with dementia and is allowed to care for six (6) hospice residents.

LPA OBSERVATIONS: Tour began at 9:55am and was led by S1. The facility is a single-story building located in a residential area with five (5) client bedrooms, one (1) staff bedroom, two (2) bathrooms, kitchen, dining room, living room, TV room, staff office, front yard, backyard, and attached garage.

Front Yard: Was clean and well maintained. No hazards were observed.

Kitchen: LPA Ramirez observed Staff #3(S3) providing meal assistance to Resident #6 (R6) at the dining room table. LPA Ramirez observed sufficient 2 days of perishables and 7-day supply on non-perishables. LPA Ramirez observed knives and sharps located in kitchen cabinet, to be inaccessible to six (6) out of six (6) residents in care. LPA Ramirez observed several bottles of cleaning solutions and disinfectants located in kitchen cabinet to be inaccessible to six (6) out of six (6) residents in care. Kitchen sink water temperature was measured at 105.9 degrees F. Kitchen appliances were observed to be clean and in working order.

Dining Room/Living room: Dining room was observed to be clean and contained one table with plenty of seating. Living room was observed to have plenty of seating and lighting. LPA Ramirez observed fully charged fire extinguisher in this area.

Linen Closet: Contained plenty linens, towels, and hygiene products.