Facility Evaluation Report

Licensing Program Analyst (LPA) Emily Peraldi arrived at the facility unannounced to conduct a required annual visit. At 12:00 p.m., the LPA met with staff and explained the reason for it visit. At 12:27 p.m., the Licensee arrived at the facility.

At 12:45 p.m., the LPA, along with the Licensee toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that the facility is in compliance with Title 22 Regulations.

KITCHEN: The LPA observed the kitchen/dining area. Knives are stored in a locked kitchen drawer. Kitchen appliances are in operable condition. The facility has a sufficient supply of perishable and non-perishable food. At 1:17 p.m., hot water measured at 106.3-degree Fahrenheit. Medications are located in a locked kitchen cabinet. However, at 12:48 p.m., the LPA observed medication accessible in the refrigerator. The Licensee explained that she will ensure that the medications will be locked and inaccessible.

BEDROOMS: The facility is a single-story residential home with three (3) bedrooms and one (1) bathroom for resident's use. There is an additional bedroom for staff use, which remains locked. The LPA observed resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Inside temperature was maintained at a comfortable level. At 12:52 p.m., the LPA observed Resident #1 (R1) residing in room three (3), which is not the identified bedridden room. Per R1’s physician’s report, R1 is identified as bedridden. Per the fire clearance, a bedridden resident can only reside in Bedroom #1. An immediate civil penalty of $500 is assessed, due to a violation of the fire clearance.