Facility Evaluation Report

Licensing Program Analyst (LPA) Nadia Shahbazian met with Elizabeth Tiku for an Annual Required visit and inspection of the facility. LPA explained the reason for the visit. The facility is a one story home, located in a residential neighborhood and consists of five (05) bedrooms, of which one (01) bedroom is for staff, and three (03) bathrooms. This Residential Care for Elderly (RCFE) is approved for residents ages 60 and above. Facility is fire cleared for one (01) ambulatory, five (05) non-ambulatory residents, of which one (01) may be bedridden in room #3 and a hospice waiver for six (06) residents. Currently there is one (1) resident on hospice.

At 12:15pm, with the assistance of administrator, LPA took a tour of the physical plant.

Required postings were observed in the dining room. The smoke/carbon monoxide detectors are hardwired and interconnected. At 12:30pm smoke/carbon monoxide detectors were posted and observed to function properly. The fire extinguisher is located in the kitchen with purchase date of 10/30/2024.

Common Areas : These included the living room and dining room. The common areas were properly furnished with tables, chairs, sofas. There is a television set and a cabinet with games in the living room. There is a linen closet in the hallway, next to bedroom # 1. Facility provides internet and cable access .

Kitchen: The kitchen appliances and fixtures were functional and consisted on stove, oven, refrigerator, microwave and dishwasher. Kitchen surfaces and appliances are clean and food is marked purchase or expiration dates. LPA found a sufficient supply of perishable (2 days) and non-perishable (7 days) foods at the facility, with plenty of dishes in the cupboards. Knives and sharp objects were stored in a locked cabinet in the kitchen.