Facility Evaluation Report

Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility at approximately 9:20 am. LPA Smith was greeted by staff and disclosed the purpose of the visit. Staff contacted the administrator. LPA Smith spoke with the administrator and disclosed purpose of the visit. Administrator revealed will arrive shortly.

LPA conducted a tour of the physical plant at approximately 11:20 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 residents. These included the kitchen, dining room area and living room. The common areas were checked for cleanliness and furniture was checked for functionality. Common areas observed to be furnished appropriately.

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

kitchen food supply was observed and sufficient for the five (5) residents currently residing there. Two (2) days of perishable and seven (7) days of nonperishable food observed. The freezer is stocked with meats and frozen vegetables. The resident medications are locked in cabinet in kitchen and observed to be locked an inaccessible to residents in care. The new first aid kit is stored in medication cabinet in kitchen. Sharps are locked in kitchen island drawer observed to be locked and inaccessible to residents. There are three (3) fire extinguishers: One (1) attached to wall in kitchen area and two (2) in laundry room. Fire extinguishers observed to be charged.

Laundry room located in at end of first hallway by enclosed patio. The appliances observed to be in good repair. Toxins stored in cabinet in laundry and under kitchen sink. Toxins observed to be locked and inaccessible to residents.