Facility Evaluation Report

Licensing Program Analyst (LPA)Wendy Gibbs conducted an unannounced visit to conduct an annual inspection using the infection control CARE tools. LPA Gibbs met with Administrator, Samuel Fairbanks and explained the purpose of the visit. The home has 5 ambulatory clients .

Structure The home consists of 3 client bedrooms, 1 staff bedroom, 2 bathrooms, living room, kitchen, dining area and family room/area.

Physical Plant Outside grounds were toured and no bodies of water were observed. There were tables and chairs on a shaded patio. All exits and walkways around the home were free of debris and hazards.

Bedrooms All client rooms were checked. Mattresses and box springs were in good condition, each bed had a mattress cover, fitted sheets, blanket, comforter and pillow. Each room had adequate lighting and required furniture such as a dresser for each resident, nightstand and closet space was observed.

Linens & Hygiene Bed linens, comforters and bath towels were adequately stocked in a closet in the hallway. Hygiene products were fully stocked.

Bathrooms Both bathrooms were in good working order. The toilets and water faucets worked properly. The shower was free of mold/mildew, had non-skid matts, and safety bars were secured. Both bathrooms had adequate lighting, and sufficient toiletries accessible to clients. Water temperature measured between 114.6-115.1 degrees F.