Facility Evaluation Report

At 9:30am, Licensing Program Analyst (LPA) Huma Rahimi conducted an unannounced visit to the facility for the purpose of ensuring health and safety compliance. LPA met with staff #1 (S1) Dinara Kundakpayeva , and the Administrator Designee was contacted via telephone. The purpose of the visit was explained.

During the visit, LPA observed two (2) staff providing care and supervision to four (4) residents . Additionally, two (2) staff members were observed cleaning and preparing breakfast for the residents. All residents appeared appropriate for a board and care living setting.

LPA conducted a review of four (4) resident files , and all records were found to be complete and up to date. At 9:40 a.m. , LPA with S1 toured the facility and observed it to be clean, well-maintained, and adequately stocked with non-perishable food supplies for at least one week and perishable food items for at least two days .

Per Administrator Designee, there have been two incidents and one death of a resident which was reported to Community Care Licensing Department (CCLD) in a timely manner.

No immediate health or safety concerns were observed during the visit. An exit interview was conducted, and a copy of this report was provided to the Designee.