Facility Evaluation Report

Licensing Program Analyst (LPA) Angela Barutyan arrived at the facility unannounced to conduct a required annual visit at 11:34AM. LPA met with Administrator Jennifer Fernandez. Entrance interview conducted.

Beginning at 11:37AM, 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:

KITCHEN: LPA inspected the kitchen at 11:37AM. Knives and sharps are stored in a locked drawer. At 11:38AM, LPA observed cleaning supplies and chemicals accessible under the sink. Administrator moved chemicals to the locked garage. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food and an emergency water supply. At 11:42AM, LPA observed an opened bottle of maple syrup and soy sauce stored in the pantry, however, bottles state to refrigerate after opening. Administrator discarded the items.

BEDROOMS : The facility consists of seven (7) total bedrooms; six (6) are designated for single-resident use and one (1) is designated for staff use and is kept locked. Bedrooms #1, #3, #4, #5, and #6 have exits to the exterior. All resident rooms were observed to be furnished appropriately with clean linens, appropriate furnishings, closet space, and sufficient lighting.

BATHROOMS : There are three (3) full bathrooms; one (1) in the main hallway and two (2) Jack and Jill's (between room #4 and staff room, and room #5 and #6). LPA observed bathrooms to be clean, sanitary and in operating condition with grab bars and slip-resistant surfaces. Hot water temperatures were measured in bathrooms and were between 106.0-106.7 degrees F. Report Continued on LIC 809-C.