Facility Evaluation Report

At 1:35 pm Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility. LPA was greeted by the administrator and disclosed purpose of visit.

LPA conducted a tour of the physical plant at approximately 1:38 pm 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 guest lounge,living room, kitchen and dining 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 six (6) 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. The medications and first aid are stored in locked upper kitchen cabinets. Sharps stored and locked in kitchen drawer beneath the medication cabinet. Medications and sharps observed to be inaccessible to residents. Toxins stored under kitchen sink cabinet and observed to be locked and inaccessible to residents.

There are two (2) fire extinguishers: one (1) in kitchen wall near refrigerator, one (1) in hallway next to bedroom # 6 attached to wall.

Laundry room in guest bathroom near dining room. The appliances observed to be functional and in good repair.