Facility Evaluation Report

Licensing Program Analyst (LPA) Shira Stamps met with Administrator Gamze Davenport for an unannounced one (1) year Required visit for this facility. LPA arrived at 10:00 am and was greeted by caregiver Robert Davenport. All residents were observed to be in their room sleeping, and/or resting. At 10:15am, the Administrator stated she was on her way. LPA informed the caregiver of the purpose of the visit and began the tour. The Administrator arrived at 11:55am.

Infection control: LPA Stamps reviewed facility mitigation plan (approved on 03/13/21) to make sure the licensee was following current infection control recommendations. Upon arrival LPA was screened by the caregiver. LPA was asked to sign-in and sanitize was available.

A tour of the physical plant was conducted with the Caregiver at 10:52 am. The facility has six (6) bedrooms and two (2) bathrooms currently occupying three (3) residents. Two (2) bedrooms are designated for staff use only. The facility is Fire Cleared for six (6) ambulatory.

LPA conducted a tour of the kitchen around 11:00 am and observed there to be sufficient stock of two-day perishables and seven-day non-perishables foods. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. LPA observed chemicals/hazardous cleaning supply on the kitchen counter.

LPA observed rooms to have the appropriate bedding. There is a nightstand and sufficient lighting for each client.