Facility Evaluation Report

Licensing Program Analyst (LPA) Trevor Byrne arrived at the facility unannounced to conduct a required annual visit at 08:59 AM. LPA contacted the facility administrator Suzie Hastings via telephone call. Facility administrator arrived to the facility at 09:18 AM Entrance interview conducted and the reason for the visit was explained.

Beginning at 09:20 AM, the LPA, along with facility administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed:

KITCHEN : The LPA observed the kitchen area to be clean. Kitchen appliances were in operable condition. The facility has a sufficient supply of two (2) days perishable and seven (7) days non-perishable food. LPA observed a secured drawer to contain knives and other sharp objects. The LPA observed the fire extinguisher to be fully charged and purchased on 05/09/2024. The water temperature was measured at 119 degrees Fahrenheit, which is in compliance with regulation.

BEDROOMS : There are three (3) bedrooms in the facility; all are designated for resident use, and one (1) designated as a dual occupancy room. LPA and facility administrator toured all three (3) resident rooms. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings and sufficient lighting.

BATHROOMS : There are two (2) bathrooms at the facility. One (1) is designated as a resident restroom and one (1) is designated as a staff restroom. Both bathrooms were observed to be clean and in good repair and all were equipped with nonskid surfaces. Grab bars were observed in the resident shower and was properly secured. The water temperature was measured in both bathrooms at 120.3 degrees Fahrenheit. Report Continued on LIC 809-C