Facility Evaluation Report

Licensing Program Analyst (LPA) Tihesha Smith made an unannounced 1-year inspection to this facility. LPA Smith was greeted by staff and disclosed the purpose of the Staff contacted the administrator who arrived later.

LPA conducted a tour of the physical plant at approximately 10:45 am to ensure there are no health and safety hazards, and facility is in compliance with Title 22 Regulations.

Common areas were observed for the ability to safely serve the needs of the residents. These included the living and dining room combination, kitchen, and family area. The common areas were checked for cleanliness and furniture was checked for functionality. Common areas observed to be clean, sanitary and have adequate seating for residents.

LPA reviewed the food service areas, food storage and supply (perishable and nonperishable foods). The

kitchen food supply was observed and sufficient for the six (6) residents currently residing there. Two (2) days of perishable food observed. The freezer is stocked with meat and frozen foods. Medication stored and locked in closet next to office. Most medication in bubble packs. Sharps are stored in kitchen drawer. Sharps observed to be locked and inaccessible to residents in care. First aid kits stored in upper cabinets in living room. Toxins are stored and locked under kitchen sink and observed to be locked and inaccessible to residents.

The facility has a total of six (6) bedrooms, each with private bathrooms and one (1) main bathroom. There is also an office and staff room.