Facility Evaluation Report

At 12:30 PM., Licensing Program Analyst (LPA) Brian Balisi arrived at the facility unannounced to conduct a required annual visit. LPA was greeted and screened by staff Marivic Sidora. LPA met with Administrator Anna Hayrapeteyn and explained the reason for the visit. This annual had a specific emphasis on infection control practices and procedures.

At approximately 1pm, LPA toured the physical plant along with Administrator. LPA inspected facility for Fire Safety, Personal Accommodations and Services, and Food Service. LPA observed Fire extinguishers to be purchased in September 2022. Smoke detectors and Carbon Monoxide detectors appeared to function properly during time of visit

Facility is a single-story residence and consists of a total of four (4) bedrooms and three (3) bathrooms. Fire clearance was approved on 7/20/2021 for four (4) non-ambulatory residents, one (1) ambulatory and one (1) bedridden. During physical plant tour LPAs observed the required postings throughout the facility. At 1:30, LPA observed residents in their rooms either sleeping or watching television.

Kitchen: The kitchen appeared to be clean and the appliances and fixtures functional during the time of visit. LPAs observed a sufficient amount of perishable and non-perishable food at the facility; properly stored. Sharp objects are stored in a cabinet in the kitchen to the right of the refrigerator. No cleaning supplies or toxins are stored under the sink. Staff bedroom next to the kitchen was observed empty at this time.

Bedrooms: The resident bedrooms were properly furnished with a bed, 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.