Facility Evaluation Report

Licensing Program Analyst (LPA) Angela Barutyan arrived at the facility unannounced to conduct a required annual visit at 11AM. LPA met with staff upon arrival and Administrator Mary Ann Howe who arrived at 11:30AM. Entrance interview conducted.

At 11:07AM, the LPA along with staff and Administrator, toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

KITCHEN: LPA inspected the kitchen/food service area at 11:07AM. Kitchen appliances appeared clean and were in operable condition at the time of the visit. The facility has a sufficient supply of perishable and nonperishable food. Food labels were inspected and checked for expiration dates and food labels had expiration date clearly marked. Knives and chemicals were locked and inaccessible in the cabinet under the sink.

BEDROOMS: There are five (5) bedrooms total; two (2) are private resident bedrooms, two (2) are shared-resident bedrooms, and one (1) is a staff room which is kept locked and inaccessible. Bedrooms #1, #3 and #5 have direct exits to the exterior. LPA observed resident bedrooms to be furnished appropriately with clean linens, appropriate furnishings, sufficient lighting, and equipped with functioning auditory exit alarms. LPA observed Resident #1 (R1) residing in Bedroom #5, however, R1’s physician’s report signed and dated 05/08/2025 marks R1 as bedridden, and the facility’s fire clearance only clears Bedroom #1 for bedridden-use. Bedroom #5 does not have fire clearance for bedridden-use. Administrator stated that R1 can reposition and self-transfer, and Administrator will contact R1's physician to get an updated physician's report regarding R1's ambulatory status.