Facility Evaluation Report

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced visit and was greeted by the caregiver. The Licensee, Marlen Lopez, was called. The Licensee had previously informed LPA the facility now has one resident. LPA Spaeth stated the purpose of the visit was to tour the facility and review the resident's file. LPA and the caregiver toured the facility at 2:35 pm to 2:54 pm.

Kitchen - LPA observed a two day supply of perishable food and a seven day supply of non-perishable food. LPA Spaeth tested the water temperature at 3:00 pm which was 110.4 Degrees F. The knives and cleaning solutions were locked in a kitchen cabinet.

Resident Room - LPA observed the resident was resting comfortably in their room.

Bathroom s - LPA Spaeth observed the bathrooms contained slip resistant mat, hand soap, grab bars, and a trash can.

Resident File/Medications - LPA reviewed the resident file at 3:10 pm until 3:45 pm. There are no issues regarding the resident's file and the resident's medications.

Smoke Detectors - The smoke detector was tested at 3:48 pm and was operable.

There are no deficiencies to report at this time. Exit interview conducted and a copy of the report was given.