Facility Evaluation Report

Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility 10:20 am. LPA was greeted by staff and disclosed the purpose of the visit. The administrator was called and arrived later.

LPA conducted a tour of the physical plant at approximately 11:05 am to ensure there are no health and safety hazards, and the facility is following Title 22 Regulations. Common areas—including the combined living and dining room, as well as the kitchen were evaluated for their ability to safely meet residents' needs. These spaces were inspected for cleanliness, and furniture was assessed for functionality and condition. All common areas were found to be clean, sanitary, and furnished with seating sufficient to accommodate residents comfortably.

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 food observed. The freezer is stocked with frozen foods. Food pantry in living cabinet stocked with canned goods and boxed foods. Resident medications and first aid kit are stored in lower kitchen cabinet and container on top of the cabinet near the kitchen table. Sharps are stored in kitchen drawer. Medications and sharps observed to be locked and inaccessible to residents in care. Toxins are stored and locked under kitchen sink and observed to be locked and inaccessible to residents. The laundry room is located behind the kitchen. The appliances observed to be functional. The locked cabinets above the washer and dryer contain toxins observed to be locked and inaccessible to residents.