Facility Evaluation Report

At 9:35 a.m. on 01/04/2022, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced annual visit. LPA met with staff and disclosed the reason for the visit. LPA and staff toured the facility inside and out. The facility was last visited on 01/27/2022 for an annual visit. It is a single story building with 4 bedrooms, 3 bathrooms, kitchen, garage, common areas, and outdoor areas. It has an approved fire clearance for 4 ambulatory residents. LPA observed a maintained front yard. Once inside, LPA observed postings for the facility’s COVID precautions, confidential complaint contacts, personal rights, grievance procedure, house rules, and weekly menu. At 9:58 a.m. LPA tested the carbon monoxide detector in the hallway to be operational. At 9:59 a.m. LPA tested the smoke detector to be operational. When tested, 2 out of 2 alarms sounded simultaneously. The facility had 4 bedrooms. 3 were private and 1 was shared. All bedrooms contained a chair, nightstand, lamp, storage, and bed with adequate bedding. All furnishings were clean and in good condition. Bedroom #2 served as the staff bedroom, and it was locked. The facility had 3 bathrooms. All bathrooms contained liquid soap, paper towels, handwashing instruction sign, trash can with a tight fitting lid, and a non-skid mat in the shower. At 10:03 a.m. LPA measured the water temperature in the shared bathroom to be 111.8 degrees Fahrenheit. Walls, floors, ceilings, windows, screens, and blinds were clean and in good repair. At 10:06 a.m. LPA measured the room temperature to be 70 degrees Fahrenheit. The living room contained leisure activities, exercise equipment, and board games. Confidential files were locked in a cabinet. LPA observed a covered patio area with furniture in good condition. Two small dogs were kept in the back yard. A shed and the garage contained hazardous materials. Both the shed and garage were locked. Both emergency exits were unlocked. All exit paths were free of obstructions. In the kitchen, LPA observed an adequate supply of perishable and non-perishable food. The stove hood was clean, and all surfaces were sanitary. Sharps and medications were locked below the counter top. Cleaning solutions and detergents were locked above the washer and dryer near the kitchen. At approximately 10:10 a.m. LPA observed a fully charged fire extinguisher in the kitchen. During today's inspection, the facility is in compliance with Title 22 regulations. No citations issued. Exit interview conducted. Copy of report provided.