Facility Evaluation Report

Licens ing Program Analyst (LPA) Tihesha Smith conducted an unannounced Annual Required visit to this facility. LPA disclosed to staff the purpose of this visit.

LPA conducted a tour at 1:40 PM the physical plant to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

Smoke alarms and carbon monoxide detectors were present and function properly. The fire extinguisher was observed to be charged.

LPA was escorted to the living and dining combination area and observed adequate seating for residents. Staff confirmed this facility does not currently have any residents residing here. The living area had furnishings and sufficient lighting. The area was clean and well kept. There were also games available for residents use to use.

LPA observed kitchen to be clean and appliances in good repair. The knives, medications and cleaning supplies to be locked in two (2) separate cabinets off or adjacent to staff bathroom. Laundry in kitchen with appliances observed to be in good repair. The first aid kit was present and stocked. LPA observed a locked door which is the staff room.

LPA observed resident bedrooms, bathrooms, personal accommodations, and common areas: all resident bedrooms toured had the required furniture for residents’ comfort and safety. Bedrooms #1 and bedroom #2 designated as non-ambulatory. Common areas were observed for the ability to safely serve the needs of residents, including cleanliness, signal system, locks, skid materials, grab bars, and comfortable temperatures.