Facility Evaluation Report

Licensing Program Analyst (LPA) Shira Stamps met with Administrator Kesha Richardson for an unannounced one (1) year Required visit for this facility.

LPA arrived at 9:50 am and was greeted by the Licensee. Two (2) residents were observed in the dining room finishing up breakfast. The other resident was observed to be in their room reading. LPA informed the Licensee of the purpose of the visit.

Infection control: The Licensee stated the mitigation plan, infection control plan, and monkey pox plan was sent to Sacramento. LPA requested the plans to be sent to the case carrying LPA. Upon arrival LPA was screened by the Licensee and asked all infection control questions. LPA was asked to sign-in and sanitizer was available.

A tour of the physical plant was conducted with Licensee at 10:27 am. The facility has seven(7) bedrooms and three (3) bathrooms currently occupying three (3) residents. One (1) bathroom and one (1) bedroom is designated for staff use only and the facility has awake staff at night. The facility is Fire Cleared for six (6) non-ambulatory, one (1) bedridden, and six (6) hospice residents. The Licensee stated the facility currently has no bedridden or hospice residents.

LPA observed the living room to be neat and clean along with the dining room and family room. The facility maintains a comfortable temperature at 78°F. The smoke detectors and carbon monoxide detectors were tested and observed to be operational at 11:00 am. There are two (2) fire extinguishers, one (1) is located in the family room and one (1) is located in the entry way. Fire extinguishers were observed to be full and last serviced on 09/23/21. CONTINUED...