Facility Evaluation Report

On 8/29/22, Licensing Program Analyst (LPA) Shira Stamps arrived at the facility for an unannounced one (1) year Required visit. LPA arrived at 10:45 am. LPA was greeted by a caregiver. LPA spoke to the Administrator over the phone and informed her of the purpose of the visit. The Administrator designated Lusia Pattriani to sign the report since she was out of town. The Administrator was able to arrive before the end of the inspection at 11:37am.

A tour of the physical plant was conducted with the Caregiver at 11:10 am. The facility has four (4) bedrooms and two (2) and bathrooms currently occupying four (4) clients. One (1) bedroom and one (1) bathroom is designated for staff use only. The facility is Fire Cleared for six (6) ambulatory.

Infection control: LPA reviewed the mitigation plan approved on 3/13/21. The facility is following current infection control recommendations. Upon arrival LPA was screened by the caregiver and asked all infection control questions. LPA was asked to sign-in and sanitizer was available.

At 11:10 am, LPA observed the living room and dining room to be neat and clean. The facility maintains a temperature of 72°F. The smoke detectors and carbon monoxide detectors were tested and observed to be operational at 11:31 am. LPA observed the locked filing cabinet storing client’s medications.

LPA conducted a tour of the kitchen around 11:13 am and observed there to be sufficient stock of two-day perishables and seven-day non-perishables foods. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas care clean and inaccessible to pests. The knives and sharp objects are kept in the locked staff room. There are two (2) fire extinguishers located in the kitchen and the hallway. The Fire extinguishers were observed to be full and last serviced 05/10/22. CONTINUED...