Facility Evaluation Report

Licensing Program Analyst (LPA) Angela Barutyan arrived at the facility unannounced to conduct a required annual visit at 12:55PM. LPA met with staff upon arrival and Administrator Vanessa Havsgaard who arrived at 01:18PM. Entrance interview conducted.

At 01:19PM, the LPA along with 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/LAUNDRY: The LPA inspected the kitchen/food service area at 01:19PM. 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. Knives and chemicals were locked and inaccessible in kitchen drawer and cabinet under the sink. LPA observed a laundry room accessed through the kitchen which is locked and inaccessible to residents in care.

BEDROOMS: There are six (6) private resident bedrooms. There is one (1) staff bedroom that is being used by staff as a private living quarter. The staff room is accessed through an attached staff bathroom. All rooms have direct access to the outside. LPA observed resident bedrooms to be furnished appropriately with clean linens, appropriate furnishings, sufficient lighting, and equipped with functioning auditory exit alarms.

RESTROOMS: There are five (5) full bathrooms; one (1) is for private staff use, two (2) are private bathrooms for resident use and two (2) are full bathrooms in the hallway that are designated for residents, staff, and guests. LPA observed resident restrooms equipped with grab bars and slip-resistant surfaces. Hot water temperature was measured in resident bathrooms and were between 105.3-107.4 degrees F, which is within the required range. Report Continued on LIC 809-C.