Facility Evaluation Report

Licensing Program Analyst (LPA) Mariana Agban conducted an Annual Required visit and inspection of the facility. LPA met with staff #1 (S1) and explained the reason for the visit. Administrator, Ruslan Levin arrived shortly after. At approximately 1:30 PM, with the assistance of the Administrator, LPA took a tour of the physical plant.

Kitchen : Required postings were observed in the kitchen. The fire extinguisher is located in the kitchen with purchase date 12/12/24. The kitchen appliances and fixtures were functional. LPA 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.

Medication Room : Medication room was observed to be locked.

Smoke detectors/carbon monoxide : Dual smoke and carbon monoxide detectors were located throughout the facility and were tested and observed to be operational.

Bedrooms: There were six (6) bedrooms designated for residents' use. All bedrooms are designated for private use. All six (6) bedrooms, in use by residents, were properly furnished with appropriate beddings and linens with sufficient lighting .

Bathrooms: There are five (5) bathrooms designated for residents' use. All bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured from the bathrooms sink at 113.8 degrees Fahrenheit. No cleaning supplies or hazardous items were present in each bathroom during the inspection.

Common Areas : These included the living room and dining area. The common areas were properly furnished. The auditory alarms on all exit doors were on and functional at the time of the visit .

Surrounding Grounds : Entry/exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards.