Facility Evaluation Report

On 05/14/2024 at 8:00 a.m. Licensing Program Analyst (LPA) Evelin Rios arrived at the facility listed above to conduct an unannounced annual inspection using the CARE Inspection Tool. LPA rang the door bell but nobody answered. LPA contacted the administrator, Salabi Aidinova by telephone and the administrator informed LPA staff had taken one (01) resident to an appointment and will be returning to the facility. Administrator also informed LPA they would arrive to the facility to meet with LPA. LPA informed administrator the reason for the visit. LPA met with staff #1 (S1) who greeted LPA and granted access. At 9:40 a.m., administrator, Salbi Aidinova met with LPA.

At approximately 9:25 a.m. LPA and S1 toured the physical plant of the facility inside and out, and the following was observed. At 9:42 a.m. LPA observed the administrator test a dual smoke and carbon monoxide detector that is hardwired and interconnected to other detectors located through out the facility. Detectors were observed to be functioning properly.

Bedrooms: LPA inspected four (4) out of four (4) client bedrooms. Bedrooms are for private use. LPA observed each client room to be properly furnished with one bed, appropriate night stand, chair, bedding and with sufficient lighting and storage. LPA observed windows with window screens in good repair.

Bathrooms: The facility has two (2) bathrooms available for clients and visitors to use. The LPA took hot water temperature from one (1) out two (2) client bathrooms and temperature measured at 117.3 degrees Fahrenheit, within regulation. LPA observed both bathrooms to be clean and properly supplied with toilet paper, hand soap, paper towels and trash bins with lids. The facility had a comfortable temperature of 70 degrees Fahrenheit. (Continued on to LIC809-C)