Facility Evaluation Report

Licensing Program Analyst (LPA) Elsie Campos arrived at the facility unannounced to conduct a required Annual visit. This annual had a specific emphasis on infection control practices and procedures. The LPA met with the Administrator Mariam Kevliyan at 10:05 a.m. and explained the reason for the visit.

The LPA toured the physical plant areas inside and outside, with Administrator Mariam Kevliyan at 10:30 a.m., to ensure there are no health and safety hazards.

BEDROOMS: There are (4) four bedrooms designated for resident use and (1) one bedroom designated for staff use. Staff bedroom is part of the attached garage adjacent to the kitchen. Bedroom #3 and Bedroom #4 have a direct exit to the exterior. The facility has furnished each room with clean linens, appropriate furnishings, and sufficient lighting for resident use. Accessible disinfectants and air freshener were observed in Bedroom #4. Oxygen was observed in Bedroom #1, yet the LPA did not observe the appropriate ‘No Smoking – Oxygen in Use’ sign.

RESTROOMS : Resident restrooms are clean, sanitary, and in operating condition with grab bars and non-skid surfaces. The LPA observed sufficient amounts of soap and paper products. The LPA observed signs in the bathroom attached to bedroom #1 and hallway bathroom promoting good hand hygiene. Restroom hot water measured at 114.3 degrees Fahrenheit at 10:55 a.m.

FILES: During today’s visit, the LPA observed full bed rails on the bed of Resident #1 (R1). The Administrator provided bed rail orders for the resident.