Facility Evaluation Report

Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility 11:45am. LPA was greeted by the staff and disclosed the purpose of the visit. The administrator was present at the facility. LPA conducted a tour of the physical plant to ensure there are no health and safety hazards, and the facility is following Title 22 Regulations.

Common areas, which include the kitchen, living room, and combined dining/sunroom 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 frozen foods. The resident medications are locked in bottom kitchen cabinet and sharps store in drawer. Both were observed to be locked and inaccessible to residents. There is one (1) fire extinguisher located under kitchen sink. The fire extinguisher observed to be charged.

The facility has a total of five (5) bedrooms and two (2) bathrooms for residents in care.

The residents’ bedrooms were properly furnished with at least one chair, nightstand, and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, and blankets.