Facility Evaluation Report

Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility at 11:20 am. LPA 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 to ensure there are no health and safety hazards, and the facility is following Title 22 Regulations.

Common areas, including the kitchen and the combined living and dining room, were evaluated for their ability to safely meet residents' needs. These spaces were inspected for cleanliness, and furniture was assessed for functionality and condition. All common areas were found to be clean, sanitary, and furnished with seating sufficient to accommodate residents comfortably.

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

kitchen food supply was observed and sufficient for the four (4) residents currently residing there. Two (2) days of perishable food observed. The freezer is stocked with frozen foods. Food pantry is located next to the refrigerator and is stocked with vegetables and boxed foods. Resident medications locked in cabinets on other side of the refrigerator. Sharps are locked and stored in kitchen drawer next to stove and toxins are stored and locked under kitchen sink and observed to be inaccessible to residents. There is one (1) fire extinguisher in facility attached to the wall in dining room and observed to be charged. The laundry room is located near bedroom #2. The appliances observed to be functional. The cabinets above washer and dryer store paper towels and supplies.