Facility Evaluation Report

Licensing Program Analysts (LPA) Erica Mosley arrived at the facility unannounced to conduct a required annual visit and entered the facility at 11:00 a.m. Upon arrival, LPA Mosley was greeted by staff and called the administrator to inform them of the visit. The administrator arrived shortly thereafter. The LPA met with Administrator MARY PETIKYAN and explained the reason for the visit. The LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

The facility is a single-story family home consisting of a living room, dining room, kitchen, 4 bedrooms, 3 full bathrooms and an attached garage. The facility is fire cleared for 5 NON-AMBULATORY and 1 BEDRIDDEN resident.

KITCHEN: The LPA inspected the kitchen/food service area at 11:17 a.m. Knives and sharps were observed in a locked cabinet. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Refrigerator and food pantry were checked for proper labels and expiration dates. The kitchen faucet was measured for hot water temperature, and it measured 110.9 degrees Fahrenheit at 11:33 a.m.

COMMON AREAS: At the time of the visit, furniture in the common areas was observed to be in good condition. The facility maintained a comfortable temperature. At 2:42 p.m., smoke detector(s) and carbon monoxide detector were tested and operational at the time of the visit. The facility has two (2) fire extinguishers that were observed and fully charged on 07/12/2024. The LPA observed required postings throughout the common space. The last emergency disaster drill took place on 08/02/2024. Activities were observed in the common areas.