Facility Evaluation Report

Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year in spection at this facility 12:40 pm. No one was present at the facility. LPA Smith contacted the Licensee who arrived shortly and disclosed the purpose of the visit.

LPA conducted a tour of the physical plant at approximately 12:55 pm to ensure there are no health and safety hazards, and the facility is following Title 22 Regulations. 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 four (4) residents currently residing there. Two (2) days of

perishable food observed. The freezer is stocked with meat and frozen foods. Food pantry in kitchen stocked with can goods and boxed foods. Resident medications and sharps are stored in lower kitchen cabinets next to the stove. Medications and sharps observed to be locked and inaccessible to residents in care. A large supply of first aid items and two (2) kits stored in large cabinet in the living room. Toxins are stored and locked under kitchen sink and observed to be locked and inaccessible to residents. The laundry room is located in the alcove at the back of kitchen. The appliances observed to be functional. The locked cabinets above washer and dryer contain laundry detergents and supplies