Facility Evaluation Report

Licensing Program Analyst (LPA) Abeye Duguma met with the administrator, Edna Provost, for a Required One (1) Year visit. LPA explained the reason for the visit. A tour of the physical plant was conducted at around 12:30 PM and the following was noted:

The facility has outdoor furniture with a covered shaded area for residents and visitors. It does not have a swimming pool/body of water.

This is a single-story property with a total of four (4) bedrooms for residents and two (2) bathrooms. The facility is fire cleared for six (6) non-ambulatory, of which one (1) may be bedridden in bedroom #3 and a hospice waiver for two (2). The facility is currently occupying six (6) residents.

The living and dining room are neat and clean. The residents' rooms are adequately furnished with appropriate lighting system. Hallways are well lit. Residents have enough personal hygiene product provided by the licensee. The bathroom was checked for cleanliness and proper operations.

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.