Facility Evaluation Report

Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility at 10:15 am. LPA observed front yard and grounds. LPA rang doorbell and knocked at the door and waited. No one was present at the facility. LPA Smith contacted the licensee and disclosed the purpose of the visit. The licensee stated staff would arrive in approximately 10 minutes. Staff arrived shortly and LPA Smith disclosed the purpose of the visit to the staff.

LPA conducted a tour of the physical plant at approximately 10:45 am 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 resident needs. These spaces were inspected for cleanliness, and furniture was assessed for functionality and condition. The common areas were found to be clean, sanitary, and furnished with seating sufficient to comfortably accommodate the resident and/or prospective residents.

LPA reviewed the food service areas, food storage and supply (perishable and nonperishable foods). The

kitchen food supply was observed and sufficient for one (1) residents currently residing there. Two (2) days of

perishable food observed. The freezer is stocked with meat and frozen foods. Then kitchen cabinets are stocked with canned goods and boxed foods. Resident medications and first aid supplies are locked in upper kitchen cabinets, toxins and sharps are locked under kitchen sink cabinet. Medications, toxins and sharps were observed to be locked and inaccessible to the residents in care.