Facility Evaluation Report

Licensing Program Analysts (LPAs) Mariana Agban and Raymond Comer conducted an Annual Required visit and inspection of the facility. LPAs met with staff and explained the reason for the visit. Administrator David Kawooya arrived shortly after. At approximately 10: 05 am, with the assistance of staff, LPAs took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms are interconnected and battery-operated. There is a carbon monoxide detector that functions properly installed in the hallway between resident rooms. The fire extinguisher is located in the dinning area with purchase date 11/29/23.

Kitchen: The kitchen appliances and fixtures were functional. LPAs found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives were stored in a locked drawer in the kitchen. Properly labeled medications were locked in one of the hallway cabinets. The laundry area is located adjacent to the kitchen area. LPAs didn't observe any chemicals hazards.

Bedrooms: There were four (4) bedrooms designated for clients' use. All four (4) bedrooms are designated for private use. LPAs inspected two (2) out (4) bedrooms, in use by clients, two (2) out of 4 were properly furnished with appropriate beddings and linens with sufficient lighting.

Bathrooms: There are three (3) bathrooms designated for clients' use. LPAs inspected main bathroom was properly supplied and had functional fixtures. Hot water temperature was measured from the bathroom sink at 112.3 degrees Fahrenheit. No cleaning supplies or hazardous items were present in the main bathroom during the inspection. LPAs observed cracked and loose floors in the main bathroom. Administrator was advised to fix the floors as this poses a potential health and safety risk for clients.

Common Areas : These included the living room and dining area. The common areas were properly furnished. Surrounding Grounds : Entry/exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. Resident Files : LPAs conducted a file review of resident records to insure compliance of licensing forms. Staff Files : LPAs also conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms. Medications : Medication and Medication Records were reviewed for proper documentation.

Exit Interview conducted, citation issued and a copy of the report delivered. Appeal Rights given.