Facility Evaluation Report

Licensing Program Analyst (LPA), Mayra Cota, conducted an unannounced annual inspection today. LPA met with Andrei Kohler and Yelly Kohler, Administrators, and the reason for the visit was explained.

The facility is licensed to serve (6) non-ambulatory residents age 60 and over; retain (6) Hospice residents. Currently, there are no residents living in the home. The facility is currently in renovations for disaster readiness.

The facility consists of living room, dining area, kitchen, laundry room, (4) resident bedrooms, (1) full and (1) half bathrooms, Caregivers’ quarters, front and backyard.

During today’s visit, LPA observed the following:

The home is clean inside and out. Exit and passageway are clear and free of obstructions. Bedrooms have the required furniture. Kitchen is clean and sanitary and appliances are operational. Bathrooms have safety grab bars and anti-slip surfaces. Extra bedding and linen are stored in a hallway closet. Laundry appliances are working properly. Porch is shaded and has sufficient seating. Porch furniture is in good repair. The facility has a back-up generator which was observed to be operational.

Administrators have up to date certificates and continue to stay current with Caregiver training. Emergency and Disaster Plan is in place. Facility also holds liability insurance.

No deficiencies noted and no citations issued. Exit interview was conducted and a copy of the report was provided.