Facility Evaluation Report

At 10:12 am Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility. No answer after ringing doorbell/knocking. LPA Smith called facility at approximately 10:25 am, House manager Brenda Frazier answered phone and verified is at the facility and will open door. LPA was greeted by staff and disclosed the purpose of the visit. The administrator was contacted and arrived within approximately 10 minutes.

LPA conducted a tour of the physical plant at approximately 10:55 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 four (4) residents currently residing there. Two (2) days of perishable food observed. The freezer is stocked with meats and frozen vegetables. Sharps, extra freezer and PPEs are stored in locked basement. The resident medications and first aid kit stored in locked cabinet above washer and dryer and observed to be inaccessible to residents.. There is one (1) fire extinguisher attached to wall in the kitchen and observed to be charged.

Laundry room is located in hallway. 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.