Facility Evaluation Report

At 7:27 am Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility. LPA was greeted by facility staff and disclosed the purpose of the visit. The administrator was contacted, and the Licensee and Administrator arrived later.

LPA conducted a tour of the physical plant at approximately 8:00 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, living room/dining combination, family room. The common areas were checked for cleanliness and furniture was checked for functionality. Common areas observed to be furnished appropriately with adequate seating for residents.

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

kitchen food supply was observed and sufficient for the three (3) residents currently residing there. Two (2) days of perishable food and seven (7) days non-perishable food observed. The freezer is stocked with meats and frozen vegetables. Canned foods stored in hallway pantry. Additional/emergency food water in backyard shed. Sharps stored and locked in kitchen drawer. The medications and first aid are stored in locked upper kitchen cabinets. Sharps and medications observed to be inaccessible to residents. Toxins stored under kitchen sink in locked in cabinet and observed to locked and inaccessible to residents.

There are three (3) fire extinguishers: one (1) in kitchen attached to side of counter, one (1) in hallway next to bedroom #4 attached to wall and one (1) near bedroom #2 attached to wall in hallway.

Laundry room in backyard alcove. The appliances observed to be functional and in good repair.