Facility Evaluation Report

An unannounced Pre-Licensing inspection visit was conducted on this day by Licensing Program Analyst (LPA) Yelena Avetisyan. When arriving to the property LPA contacted administrator to complete the pre-inspection COVID 19 questions. Upon entrance to the facility LPA met with staff Edgar Prepuse and Marissa Agngarayngay. Temperature check and screening for LPA was completed by staff.

BEDROOMS: The physical plant was toured inside and out. A fire clearance was approved on 7/26/2021 for the following. Room # 2 is cleared for 2 ambulatory, Room # 3 is cleared for 1 non-ambulatory, Room # 4 is cleared for 1 non-ambulatory and Room # 5 is cleared for 2 non-ambulatory one of which may be bedridden. This facility has four resident bedrooms. One out of four rooms (Room #5) has a direct exit to the exterior. Rooms were set up with beds, night stands, lamps, chests of drawers, chairs and closet space. Lighting in the rooms was adequate. Room # 1 is the designated staff room.

BATHROOMS: There are 2 full bathrooms. One out of four rooms (Room #5) has an en-suite bathroom. Bathrooms are clean and sanitary and in operating condition with appropriately stalled grab bars and non-skid mats in the showers.

KITCHEN: Kitchen knives and sharp objects will be kept locked and inaccessible in locked drawers, Kitchen appliances were in operable condition. The facility had a sufficient supply of non-perishable food. The supply of dishes was adequate. The fire extinguisher is in the kitchen and was inspected in 5/2021. There is adequate seating for dining in the dinning are. Medications will be stored in a locked cabinet in the kitchen. There was a washer and dryer area in the kitchen near the staff room.