Facility Evaluation Report

Licensing Program Analyst (LPAs), Tihesha Smith and Gina Saucedo conducted an unannounced Required 1-year inspection at this facility 10:20 am. LPA disclosed to the staff the purpose of the visit. The administrator was called and arrived later.

LPA conducted a tour of the physical plant at approximately 10:50 am to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

Common areas were observed for the ability to safely serve the needs residents. These included the kitchen with breakfast nook area, formal dining room and living room. The common areas were checked for cleanliness and furniture was checked for functionality. Common areas observed to have adequate seating for residents.

LPA reviewed the food service areas, food storage and supply (perishable and nonperishable foods). The

kitchen food supply was observed and sufficient for the six (6) residents currently residing there. Two (2) days of perishable food observed. The freezer is stocked with meats and frozen vegetables. Secondary fridge in detached garage with excess food items. Resident medications and stocked first aid kits stored in cabinets in laundry area. Medications observed to be locked and inaccessible to residents in care. Toxins are stored and locked in laundry room in lower cabinet. The cabinet containing the toxins observed to be locked and inaccessible to residents.

The sharps are stored in same locked cabinet as the toxins. There is one (1) fire extinguisher attached to wall in breakfast nook area.

Laundry room is located at back of kitchen. The appliances observed to be functional.