Facility Evaluation Report

Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility LPA knocked on door and waited approximately 30 minutes before staff came to front door.LPA disclosed to staff the purpose of the visit.

LPA conducted a tour of the physical plant at approximately 11:20 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 living room, dining room, family room and kitchen. The common areas were checked for cleanliness and furniture was checked for functionality. Common areas observed to have adequate seating for residents, however areas required cleaning. Dinning room table filled with office paperwork and trash. Facility has foul odor.

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

kitchen food supply was observed and sufficient for the three (3) residents currently residing there. Two (2) days of perishable food observed. The freezer is stocked with meats and frozen vegetables. Pantry filled with canned goods and cluttered with administrator personal items.

Resident medications, sharps and first aid supplies stored in roller cabinet drawers near sliding door in kitchen Medications and sharps observed to be locked and inaccessible to residents in care.

There are two (2) fire extinguishers on in kitchen and one upstairs attached to wall. Fire extinguisher observed to be charged and replacement fire extinguishers on hand.

Laundry room is located upstairs next to bathroom. The appliances observed to be in functional.