Facility Evaluation Report

Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility. LPA was greeted by staff and disclosed the purpose of the visit. The administrator was not present and staff contacted licensee and designee arrived later.

LPA conducted a tour of the physical plant at approximately 8:40 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 kitchen, dining room, and living room. The common areas were checked for cleanliness and furniture was checked for functionality. Common areas observed to be furnished appropriately with 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 meats and frozen vegetables. Sharps are stored in locked kitchen island drawer. The residents’ medications and first aid kit were stored in locked kitchen cabinet next to glass door and were observed to be locked and inaccessible to residents. There are two (2) fire extinguisher on the floor in the kitchen next to medication cabinet and observed to be charged.

The facility has a total of seven (7) bedrooms and five (5) bathrooms, The six (6) residents’ bedrooms were properly furnished with at least one chair, nightstand, and sufficient lighting for each resident. The bedrooms