Facility Evaluation Report

Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility at approximately 9:45 am. LPA Smith was greeted by staff and disclosed the purpose of the visit. The administrator was contacted and arrived later.

LPA conducted a tour of the physical plant at approximately 10:25 am to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

Common areas were observed for the ability to safely serve the needs residents. These included the kitchen, dining room area and living room. The common areas were checked for cleanliness and furniture was checked for functionality. Common areas observed to be furnished appropriately.

LPA reviewed the food service areas, food storage and supply (perishable and nonperishable foods). The

kitchen food supply was observed and sufficient for the six (6) residents currently residing there. Two (2) days of perishable food observed. The freezer is stocked with meats and frozen vegetables. Sharps are stored in two (2) locked kitchen drawers near stove. The resident medications are locked in office cabinets and locked in hallway closet/first aid kits. The medications were observed to be inaccessible to residents. There is one (1) fire extinguisher attached to wall in laundry area. Fire extinguisher observed to be charged.

Laundry room is in kitchen behind accordion style doors. The appliances observed to be functional. Toxins stored in locked cabinet above washer and dryer. Toxins observed to be locked and inaccessible to residents.

The facility has a total of six (6) bedrooms and four (4) bathrooms. There are five (5) bedrooms for residents and one (1) bedroom for staff and three (3) bathrooms for residents.