Facility Evaluation Report

Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility 10:55 am. LPA was greeted by the administrator and disclosed the purpose of the visit.

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, including the living room and the combined kitchen and dining room, 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. Food pantry is located in laundry room stocked with vegetables and boxed foods. Resident medications locked in closet near entry. Sharps and toxins are stored and locked under kitchen sink and observed to be locked and inaccessible to residents. There is one (1) fire extinguisher in facility attached to the wall in kitchen and observed to be charged.

Laundry room is located in separated room at side of kitchen. The appliances observed to be functional. The locked cabinets above washer and dryer contain laundry detergents and supplies.