Facility Evaluation Report

Licensing Program Analyst (LPA), Abeye Duguma, conducted an announced Pre-licensing visit at around 1:30 PM and met with administrator, Nelson Jabon. LPA conducted an entrance interview with the Administrator.

With the assistance of the Administrator, LPA conducted a facility tour of both the inside and outside. The facility was inspected for Fire Safety, Personal Accommodations and Services, Medication Procedures and Food Service. This is a single-story property. Fire Clearance is approved for five (05) non-ambulatory and one (01) bedridden resident.

Facility has three (03) semi-private bedrooms and one (01) bathroom for residents and one (01) bedroom for staff with its own bathroom. Resident bathroom has properly installed grab bars and shower has non-skid mat. All residents’ bedrooms are adequately furnished. The linens are stored in the storage space located in the hallway. Towels and washcloths are not shared.

The common areas are appropriately furnished. The living room and dining room are neat and clean. The LPA observed entertainment equipment and games for activities. Fireplace has appropriate screen. There is sufficient outdoor space with seating and a shaded area with proper furniture for outdoor use. There are no bodies of water on the premises.

LPA inspected the kitchen and observed the stove and refrigerator to be clean and working. Facility has sufficient quantity and variety of nonperishable food supply. Nonperishable foods are stored in the pantry. Sharps observed to be stored in a locked kitchen drawer. All garbage containers observed to have lids.