Facility Evaluation Report

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a required annual visit at 10:24AM. LPA met with staff. Administrator Sara Golfeiz arrived at 11:05AM. Entrance interview conducted.

Beginning at 11:15AM, the LPA, along with the Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. The following was observed:

COMMON SPACES/AMENITIES: Common areas include the living room and family room. Common areas were appropriately furnished and in good condition. There is a functioning telephone on the premises. Emergency exiting plans/sketch, emergency telephone numbers, and required postings are posted in the entryway.

BEDROOMS: The facility has six (6) bedrooms of which four (4) are designated for single-resident use, one (1) is designated for shared-resident use, and one (1) is a staff room. Staff room remains locked at all times. All bedrooms were furnished appropriately with clean linens, furnishings, and sufficient lighting. All bedrooms have exits to the exterior with functioning auditory exit alarms. Administrator stated permits were secured to convert one resident room to a resident room and a staff room. Documents were submitted to CCL upon completion of construction earlier in the month. LPA Dulek will follow up with the case-LPA related to these documents and fire clearance.

BATHROOMS: The facility has five (5) bathrooms; three (3) are for resident use and two (2) are for staff use. LPA observed resident restrooms to be equipped with grab bars near the toilet and shower/tub and