Facility Evaluation Report

Licensing Program Analyst (LPA), Tuesday Cabiness conducted an unannounced annual required visit. LPA was greeted by caregiver Nataliia Savostenko, who allowed LPA to enter. She was informed the reason of the visit. Administrator Renata Guzauskiene was contacted; but was not able to attend, due to being out of the country. The current census is (4).

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

Common areas : Living/dining/and kitchen area observed to be clean. Kitchen : LPA reviewed the food service areas, food storage and supply (perishable and nonperishable foods). The kitchen food supply was observed and sufficient for the for residents currently in the home. The freezer is stocked with meats and frozen foods; with an extra refrigerator located in the garage. Food pantry in kitchen stocked with can goods and boxed foods. Medications and sharps are stored in kitchen cabinets. First aid kit was inspected. Toxins are stored and locked in the laundry room; they were locked and inaccessible to residents. Bedrooms: The facility has (4) bedrooms residents; (2) shared and (2) private. Resident's rooms have appropriate lighting, furniture, bedding, and linens. There are sufficient linens observed and available . Bathrooms: There are (2); all were clean, with soap and towels. Hot water was checked at 107.2 degrees. Surrounding Grounds: There were no visible hazards; passageways were free from obstruction and gates were easily accessible to open. Fire extinguisher fully charged. First aid kit furnished fully equipped. Smoke alarms and carbon monoxide detectors are functioning. Record review: A complete record review of staff and residents were conducted. Exit interview and copy of report provided.