Facility Evaluation Report

Licensing Program Analysts (LPA) Elizabeth Irra conducted an annual inspection visit. LPA was allowed entry by Shaunda Williams. LPA discussed the purpose of today’s visit.

This is a 2- story home which consist of (3) bedrooms, (2) bathrooms, living room, kitchen, dining area, office (upstairs) and an attached garage with the laundry unit.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

Infection Control: Facility does has an Infection Control Plan in place.

Operational Requirements: Facility is adhering to the operational requirements.

Physical Plant & Environment Safety: LPA toured facility grounds. Fire smoke alarms tested and operable. Carbon Monoxide is located near the kitchen and it was tested and is operable. The fire extinguisher is located in the kitchen and appears to be full. Hot water temperature measured within regulations. The hot water supply measured at the following temperatures: 108.0*. Bathrooms had non-skid surfaces and grab bars.

Staffing : Facility is adhering to staffing requirements.

Personnel Records-Training : Staff files are maintained at the facility. LPA reviewed staff files for Facility Administrator/S-1 through Staff #3 (S-3). Staff have current First Aid/CPR certification. Staff have their Health Screening and Tuberculosis Screening on file.

**Refer to LIC 809C for the continuation of this report.**