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. At approximately 9:50 am, with the assistance of staff, LPA took a tour of the physical plant to ensure the health and safety of the residents are protected and that the physical plant complies with Title 22 Regulations. Required postings were observed in the entry area. The facility is a two-story building. From the first floor, there is a stairwell that leads to the 2nd floor. The stairwell has a door that is being kept locked. On the 2nd floor, there are two bedrooms, each has a bathroom and two balconies. The 2nd floor is furnished. Staff#1 (S1) stated that the 2nd floor is being used by other staff members.

Kitchen: 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. Properly labeled medications were locked in one of the kitchen cabinets. The fire extinguisher is located in the kitchen with a purchase date of March 9, 2025.

Bedrooms: There were four (4) bedrooms designated for residents' use. Three (3) bedrooms are designated for private use, and one (1) room is shared. All four bedrooms, in use by residents, were properly furnished with appropriate bedding and linens, with sufficient lighting.

Bathrooms: There are two (2) bathrooms designated for residents' use. Both bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured from the bathroom sink at 106.8 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 dining room table is large enough to seat the capacity of the facility. Seating such as couches where in good repair and sat the capacity of the facility.