Facility Evaluation Report

Licensing Program Analyst (LPA) Sanjay Vaid conducted an unannounced annual inspection visit. LPA met with Glen Oriemo , Lead Caregiver. Administrator was not available to join today. The facility is licensed to serve 6 non-ambulatory residents (age range from 60 years old and over), including 1 bedridden. Facility has hospice care waiver for 4 residents. The annual fees were current. LPA explained the purpose of today's visit and the inspection to the administrator via telephone, Caregiver Oriemo assisted with the facility tour.

During the visit, Care tools, staff/resident interviews and physical plant were conducted; food supply, staff/residents files and medications were reviewed.

The facility is a single-story home located in a residential neighborhood consisting of 6 residents bedrooms, 2 bathrooms, a living room, a dining area, kitchen, laundry area in the garage, a garage, and an outdoor activity area at the backyard. The yard has a shaded area and free of debris/ hazard. Bathrooms are clean and operational. Sufficient supply of 2-day perishable and 7-day non-perishable foods. Adequate linen and personal hygiene supply. Smoke detectors are combined with carbon monoxide detectors and are operable and in compliance.

All resident bedrooms were toured. Each bedroom has a bed, linen, dresser, and lighting. The facility has one (1) fire extinguisher that is fully charged in kitchen. Cleaning supplies and toxic substances are inaccessible locked in hallway closet. Freezers are maintained at a temperature of 0-degree F and the refrigerators at a maximum of 40 degrees F. There are no firearms or weapons stored at the facility The resident bathrooms have the required grab-bars and non-skid mats. The hot water temperature in the bathrooms were measured between the required range of 105-120 degrees F.