Facility Evaluation Report

Licensing Program Analyst (LPA) Jerome Haley conducted an unannounced visit for the purpose of conducting a required one-year annual inspection. LPA was greeted, granted entry by staff and explained the reason for the visit.

The facility is a single level structure and licensed for six non-ambulatory residents. The facility currently has six residents and all six residents were present during the visit. There’s a total of 6 bedrooms of and 4 restrooms available. There’s a living room space, a dining space, laundry area, backyard area and an attached garage. Bedrooms: All bedrooms have the required furnishings: bed, lamp, chair, and storage space. Bathroom(s): Bathrooms are equipped with a working toilet, wash basin, and shower. Hot water measured in between 111.5 – 113.5 degrees F. Kitchen: 4 of 4 burners and the warmer were operational on the gas stove. Sharps are stored in a drawer near the sink equipped with a lock. Soaps and cleaning chemicals are stored below the sink. Food Service: A food supply that meets regulation requirements was observed.

Client & Staff Files : Resident and staff files are located in locked bins stored in a hallway cabinet.

File Review: Three resident files and three staff files were reviewed during the inspection.

Medications/First-Aid Kit: Client medications are stored in a kitchen drawer equipped with a lock. A first aid kit with all the required elements was observed in the hallway cabinet near the secured staff and resident files.

Medication Review: Three resident medications were reviewed during the visit.