Facility Evaluation Report

At 10:07 am Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility. LPA was greeted by the administrator and informed all residents are at a day program. LPA conducted a tour of the physical plant at approximately 10:18 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 room, kitchen, and dining 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 five (5) residents currently residing there. Two (2) days of perishable food 7 days non-perishable food observed. The freezer is stocked with meats and frozen vegetables. There are two (2) additional stocked refrigerators in the garage. Canned goods and extra supply of food stored in pantry hall closet. Sharps/toxins stored and locked under kitchen sink; observed to be inaccessible to residents. Medication cart stored in medication in front office room and observed to be inaccessible to residents.

There are three (3) fire extinguishers: one (1) attached to wall in kitchen, one (1) attached to wall in hallway near exit and one (1) attached to patio wall. Fire extinguishers observed to be charged.

Laundry room is in the garage. The appliances observed to be functional. First aid kit attached to office wall and additional supplies in second hallway closet.