Facility Evaluation Report

Licensing Program Analyst (LPA) Brian Balisi arrived to this facility today to conduct a One (1) year Required inspection of this facility with emphasis on infection control practices and procedures. LPA met with caregiver Wynn and explained the reason for the visit. LPA spoke with Administrator Sarkis over the phone, who stated it was okay for Wynn to sign for the report.

A tour of the physical plant was conducted with Wynn approximately between 10:30am - 12:30pm LPA inspected facility for Fire Safety, Personal Accommodations and Services, and Food Service. The following was noted: The facility has three (3) bedrooms and two (2) bathrooms currently occupying five (5) residents. One (1) bathroom is designated for staff use.

All smoke alarms and carbon monoxide detector were tested and functioned properly during time of visit. LPA observed all required postings in the living area. The facility serves residents with dementia, the auditory alarms on the exit doors were tested and functioned properly at the time of visit.

Kitchen: The kitchen appeared clean and the appliances and fixtures functional during the time of visit. LPA observed a sufficient amount of perishable and non-perishable food at the facility; Sharp objects are stored in a locked drawer to the right of the dishwasher. Medication is stored in a locked cabinet above the dishwasher.

Bedrooms: The resident bedrooms were properly furnished with at least one chair, night stand and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets.