Facility Evaluation Report

Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility at approximately 10:24 am. Upon entry LPA Smith disclosed to staff the purpose of the visit. The administrator was not present at the facility and was contacted by staff.

LPA conducted a tour of the physical plant at approximately 10:50 am to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

Common areas were observed for the ability to safely serve the needs residents. These included the living room and kitchen/dining room combination. The common areas were checked for cleanliness and furniture was checked for functionality. Common areas observed and the following is noted:

The floors in the entire facility are being upgraded from carpet to hardwood floor laminate therefore items in pantry, living room and bedrooms have been relocated to either kitchen or backyard patio.

LPA reviewed the food service areas, food storage and supply (perishable and nonperishable foods). The

kitchen food supply was observed and sufficient for the four (4) residents currently residing there. Two (2) days of

perishable food observed. However, bananas and green vegetables located on table and counter had rotten. The freezer is stocked with meats and frozen vegetables. Food pantry located in hallway by front door.

Resident medications and sharps stored in locked metal cabinet. Medications and sharps observed to be locked and inaccessible to residents in care. Toxins are stored and locked in laundry room in wardrobe cabinet. The sharps are stored in locked metal cabinet in laundry room. There is one (1) fire extinguisher attached to wall in the kitchen and observed to be charged.

Laundry room is located in locked staff. The appliances observed to be functional.