Facility Evaluation Report

Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility 9:30 am LPA was greeted by staff Celine Taylor and disclosed the purpose of the visit.

LPA conducted a tour of the physical plant at approximately 9:50 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/dining room combination, kitchen, and den/office combination. The common areas were checked for cleanliness and furniture was checked for functionality. Common areas observed to have 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 three (3) residents currently residing there. Two (2) days of

perishable food observed. The freezer is stocked with meats and frozen vegetables. Resident medications are stored in wall mounted metal cabinet in dining area. Medications observed to be locked and inaccessible to residents in care. Sharps are locked in staff room, observed to be in accessible to residents. Toxins are stored and locked in pantry room, in main bathroom bottom cabinet and in garage. Toxins observed to be inaccessible to residents. There is one (1) fire extinguisher attached to wall in kitchen and observed to be charged.

Laundry room is located at end of kitchen next to exit door. The appliances observed to be clean and functional.