Facility Evaluation Report

Licensing Program Analyst (LPA) Zabel Chochian conducted a Required Annual visit today at this location. Upon arrival LPA met with staff. Introductions conducted and purpose of visit was stated. Staff contacted administration. LPA observed four (4) clients and four (4) staff at the home.

At approximately 9:30am, a physical plant tour was conducted with Administrator. Facility has five (5) client bedrooms and four (4) bathrooms, currently occupying three (3) residents in three (3) private and one (1) shared bedroom. Required posting observed to be displayed properly at the facility. The facility is fire cleared for six (6) bedridden residents. Bedrooms were toured and observed to be clean and properly furnished. Linen storage was also checked and observed to have ample supply of clean linen and towels for each client. Bathrooms were observed to be clean and sanitary with necessary supplies. Hot water temperature measured at 108.0°F and within the required range. Kitchen area was observed to be clean and sanitary. All the toxins, cleaning solutions and disinfectants are locked in the cabinets. Food . The facility is observed to have sufficient food supply for the clients both perishable and non-perishable. Facility temperature observed set at 72.0°F. Laundry room is located in between bedrooms. Cleaning solutions and laundry detergents are observed kept in a locked cabinet in the laundry. Fire extinguisher observed to be operable and last check on 12/2022. Dual smoke/carbon monoxide alarm were installed all over the facility. Alarms are hardwired and interconnected and were tested and observed to be operable. The facility is equipped with fire sprinkler system. Physical plant was checked for cleanliness and condition. Facility was in good repair and observed to be clean and free of clutter during today's visit. Living and dining room furniture were also checked for functionality (wear and tear). Furniture was observed to be in good condition. Garage is attached to the house but has no access from the inside. Garage is also being used as emergency food, nursing and other supplies and old equipment storage. No body of water/pool observed.