Facility Evaluation Report

Licensing Program Analyst (LPA) Sanjay Vaid conducted an announced visit to the facility. The facility serves six (6) non-ambulatory elderly residents of which one (1) may be bedridden, ages 60 and above. Facility is approved for five (5) hospice residents.

LPA Vaid met with Licensee Gladys Pervez whom assisted with the final inspection of two new rooms addition to the facility.

All documents were provided by the Licensee and approved by the Department.

The Licensee has added two bedrooms and one bathroom to the existing facility floor plan.

The two (2) new rooms have the required furnishings: bed with linens, night table and lamp, chair, sufficient closet space, egress alarms on the sliding door, alarms are operational.

Bathroom: Observed with non skid mats, grab bar, toilet and shower are operational, water temperature measured at 106.3 deg F.

Pathways are free of debris and obstruction, toxins and sharps are inaccessible to clients in care.

LPA and Licensee toured the facility and did not observe any health and safety concerns.

Exit interview was conducted and copy of this report was provided to the Licensee, Gladys Pervez.