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. Upon arrival LPA met with head caregiver Zhyparkul Mursamambetova and explained the reason for the visit. Assistant Administrator Elena Kordonsky arrived shortly after.

At approx 9:30am, LPA inspected facility for Fire Safety, Personal Accommodations and Services, and Food Service. The following was noted: A tour of the physical plant was conducted. The facility has three (3) bedrooms and two (2) bathrooms currently occupying four (4) residents. One (1) bathroom is designated for staff use only, but is available for residents if needed.

All smoke alarms and carbon monoxide detector were tested and functioned properly during time of visit. LPA observed 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.

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.

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.

LPA observed all bathrooms were clean, properly supplied and had functional fixtures. LPA observed grab bars and non-skid mats in the bathroom Residents have sufficient amounts of supplies for personal hygiene stored in the designated staff bathroom.