Facility Evaluation Report

Licensing Program Analyst (LPA) Shira Stamps arrived at the facility for an unannounced one (1) year Required visit. LPA arrived at 10:10 am and knocked on the door but there was no answer. LPA called the Administrator at 10:19 am, and stated she was on her way over to the facility. The Administrator arrived at 10:40 am, and LPA informed the Administrator of the purpose of the visit.

A tour of the physical plant was conducted with the Administrator at 10:48 am. The facility has three (3) bedrooms and two (2) bathrooms currently occupying four (4) clients. One (1) bedroom and one (1) bathroom is designated for staff use only. The facility is Fire Cleared for four (4) ambulatory.

Infection control: LPA reviewed the mitigation plan approved on 2/20/21. The facility is following current infection control recommendations. Upon arrival LPA was screened by the caregiver and asked all infection control questions. LPA was asked to sign-in and sanitizer was available.

At 10:52 am, LPA observed the living room to be neat and clean. The facility maintains a temperature of 73°F. The smoke detectors and carbon monoxide detectors were tested and observed to be operational at 11:00 am. LPA observed the client files and first aid kit located in the entry way.

LPA conducted a tour of the kitchen around 10:48 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 care clean and inaccessible to pests. There is one (1) fire extinguisher located in the kitchen. The Fire extinguisher was observed to be full and last serviced 10/12/21. The medication cabinet was observed to be locked in the kitchen.