Facility Evaluation Report

Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility. LPA was greeted by staff and disclosed the purpose of the visit. The administrator not present and house manager was contacted and arrived later.

LPA conducted a tour of the physical plant at approximately 10:10 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 of the residents. These included the kitchen and dining/living room combination. 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 two (2) residents currently residing there. Two (2) days of perishable food observed. The freezer is stocked with meats and frozen vegetables. Sharps are stored in locked kitchen drawer. The residents’ medications and first aid kit were stored in locked hall closet next to main bathroom and were observed to be locked and inaccessible to residents. There is one (1) fire extinguisher attached to the dining room wall and observed to be charged.

Laundry room is located in garage which is locked and inaccessible to residents. The appliances observed to be functional. Toxins stored in garage and in hall closet next to staff office and were observed to be locked