Facility Evaluation Report

Licensing Program Analyst (LPA) Angela Barutyan arrived at the facility unannounced to conduct a required annual visit at 9:50AM. LPA met with Licensee/Administrator Susan Caldwell. Entrance interview conducted.

Beginning at 9:52AM, the LPA, along with 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/LAUNDRY: Kitchen appliances appeared clean and were in operable condition at time of visit. Facility had a sufficient supply of perishable and nonperishable food. Food labels were inspected and checked for expiration dates. Knives and sharps were stored locked in staff bathroom by kitchen. Cleaning supplies, washer and dryer, and detergents were located in the locked laundry room adjacent to the kitchen.

BEDROOMS : There are five (5) total bedrooms in the facility; four (4) are designated as private resident rooms and one (1) is a shared resident room. Bedrooms #1, #3, #4, 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 .

BATHROOMS : There are five (5) total bathrooms; four (4) are for resident use and one (1) is kept locked for staff use and medication/sharps storage. LPA observed resident restrooms equipped with grab bars and slip-resistant surfaces. Hot water temperature was measured in resident bathrooms and were within the required range. Report Continued on LIC809-C.