Facility Evaluation Report

Licensing Program Analyst (LPA) Abeye Duguma met with Jocelyn Sinon for a One (1) Year Required annual inspection visit. LPA explained the reason for the visit. A tour of the physical plant was conducted at 09:40am and the following was noted:

The facility has a total of five (5) bedrooms, five (5) of which are designated for resident use. Resident bedrooms were observed to be appropriately furnished. There are three (3) bathrooms in the facility and were observed to have non-skid mats and appropriate grab bars installed. The facility is fire cleared for five (5) non-ambulatory and one (1) bedridden resident. The facility is currently occupying four (4) residents present in the facility of which three (03) are receiving hospice services. All residents appear to be clean and groomed.

The facility has outdoor furniture with a covered shaded area for residents and visitors. The facility does not have a swimming pool/body of water. The garage is currently being used for storage and laundry. Laundry detergents, cleaning agents and other toxins are locked away.

Kitchen is sufficiently stocked with at least two (2) days perishable and seven (7) days non-perishable food. Frozen foods are wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Knives and sharps are observed to be locked and inaccessible to residents.

Living and dining room furniture were also checked. The living and dining room are neat and clean. The facility maintains a comfortable temperature at 75°F.