Facility Evaluation Report

Licensing Program Analyst (LPA) Tihesha Smith met with Karla Plata for a Required One (01) Year visit. LPA explained the reason for the visit. LPA conducted a tour of the physical plant at approximately 10:30 am to ensure there are no health and safety hazards, and the facility is following Title 22 Regulations.

The facility is currently utilizing a single entrance for access. Common areas—including the combined living and dining room, as well as the kitchen were evaluated for their ability to safely meet residents' needs. These spaces were inspected for cleanliness, and furniture was assessed for functionality and condition. All common areas were found to be clean, sanitary, and furnished with seating sufficient to accommodate residents comfortably.

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 frozen foods to include meats and vegetables. Food pantry is located in the laundry room. Resident medications and first aid kits stored in large cabinet in laundry area. Medications observed to be locked and inaccessible to residents in care. Toxins are stored and locked in laundry room in wardrobe cabinet. The cabinet containing the toxins observed to be locked and inaccessible to residents. Laundry room appliances were observed to be functional.

The sharps are stored in a locked metal cabinet in the laundry room. One (1) fire extinguisher attached to the wall in the kitchen observed to be charged.