Facility Evaluation Report

Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility 11:55 am. LPA disclosed to the administrator the purpose of the visit.

LPA conducted a tour of the physical plant at approximately 11:56 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 kitchen/dining room combination, living room and family room. The common areas were checked for cleanliness and furniture was checked for functionality. Common areas observed to be furnished appropriately with adequate seating for residents.

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

kitchen food supply was observed and sufficient for the six (6) residents currently residing there. Two (2) days of

perishable food observed. The freezer is stocked with meats and frozen vegetables. Emergency food pantry in hall closet. Sharps are stored in locked bottom kitchen cabinet. The resident medications stored in locked top kitchen cabinet and observed to be inaccessible to residents. The first aid kit and manual readily accessible on counter below medication storage. There is one (1) fire extinguisher attached to wall in the kitchen and observed to be charged.

Laundry room is located adjacent to kitchen. The appliances observed to be functional. Toxins stored above in locked cabinet above washer and dryer was observed to be locked and inaccessible to residents.