Facility Evaluation Report

At 2:00pm, Licensing Program Analysts (LPAs) Angela Panushkina and Perchui Milena Khurshudyan arrived at the facility to conduct an annual inspection. LPAs met with the House Manager and explained the reason for the visit.

A tour of the physical plant was initiated at 2:05pm and the following was observed:

The facility is cleared for six (6) Non-Ambulatory of which one (1) may be bedridden in room 3 only. Facility also has a approved hospice waiver for six (6) residents.

Kitchen: The kitchen area is equipped with a refrigerator, microwave oven and sink. LPA observed there to be sufficient stock of perishable and non-perishable foods. Food storage and preparation areas are clean and inaccessible to pests. All knives were observed to be locked in the kitchen cabinet. The fire extinguisher was purchased on 11/15/2024.

Medications: Medications and resident/staff files are kept in locked closet, located in a hallway. There is a complete first-aid kit it with all required supplies and with the first aid manual. LPAs also observed (insulin, and narcotic) medications stored in a small fridge

Bedrooms: The facility has a total of ten (10) bedrooms of which six (6) are designated for residents use. Four (4) bedrooms are for live-in staff. The bedrooms are appropriately furnished with sufficient closet space and have sufficient lighting. All exit doors will have an auditory alarm. LPAs also observed that three (3) out of five (5) residents have 1/2 bed rail, however, upon review of files, no doctors order was available/observed.