Facility Evaluation Report

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced visit and was greeted by the caregiver, Gabriela Gagarin. LPA stated the purpose of the visit was to conduct an annual inspection. The caregiver confirmed there are three residents living in the facility. The facility is licensed for two (2) ambulatory and four (4) non-ambulatory residents and a hospice waiver for one resident. The Administrator, Fabiola Igid arrived to the facility.

LPA Spaeth and the caregiver toured the location at 12:15 pm until 12:45 pm.

Common Areas – The living room and dining room are combined. The living room was furnished with comfortable seating. The dining room contained dining room table and chairs. The family room contained a television and comfortable seating.

Medications: LPA observed the resident medications were safely locked in a cabinet in the living room. At 12:20 pm, LPA observed a first aid kit which contained a pair scissors was not securely locked in the medication cabinet. At 12:20 pm, LPA observed the caregiver locked the scissors in the medication cabinet.

Kitchen – LPA observed a two day supply of perishable food and a seven day supply of non-perishable food items. The knives and cleaning solutions were locked underneath the kitchen sink. The fire extinguisher was located in the kitchen and was operable.