Facility Evaluation Report

Licensing Program Analyst (LPA) Vaid conducted an unannounced licensing annual inspection. Residential Care for Elderly to serve residents for age 60 and above. The LPA met administrator Barbara Boiston. The approved capacity is six (6) non-ambulatories. Facility has an approved Dementia Care Plan. Hospice waiver is approved for six (6). Fire clearance was granted for six (6) non-ambulatory and zero (0) bedridden. Fire clearance and Dementia care plan are in place. Auditory devices are installed at all exits and operable. Bedroom#1 and #3 are approved for one (1) non- ambulatory in each room. Bedrooms #2 and #4 are approved for two (2) non- ambulatories in each room.

Today’s visit consisted of staff and residents’ interviews, LPA inspected medications, food supply, toured the physical plant, reviewed resident/staff files.

The property is a single-family residence located in a neighborhood, consisting of four (4) bedrooms, two (2) full bathrooms, one (1) half bathroom, kitchen, dining room, living room with TV, laundry room, family room, and attached garage used for storage. Passageways, walkways and patios are free from obstructions. The entrance and side areas are free of hazards and debris. Garage is not accessible to residents. Bedrooms have nightstands, adequate lighting, adequate closet and drawer space. Toilet, wash basin, bathtub/shower in bathrooms are operable. Grab bars are maintained for each toilet, bathtub and shower. Adequate supply of linen, wash clothes and towels are observed. Knives, cutlery and other sharp kitchen utensils are stored in a locked cabinet in the kitchen and inaccessible to residents. Food supply consists of two days of perishable and two weeks of non-perishable was observed. Medication cabinet is locked and inaccessible to residents. First aid kit first aid manual from American red cross was available for staff use and inaccessible to residents.