Facility Evaluation Report

Licensing Program Analyst (LPA) Ruth Martinez is conducting this unannounced visit for the purpose of completing an annual inspection. LPA arrived at the facility was greeted at the door by caregiver and granted entry. Six (6) residents currently reside at this location and hospice services are being provided to four (4) residents at this time.

LPA began the tour of the inside and outside of the facility which is a one story home with attached garage. LPA observed that the facility stays within the capacity limitations. There are no bodies of water or firearms at this location.

There is a minimum of one week of non-perishable foods and two days of perishable foods available. There is additional food storage in the attached garage in refrigerator and freezer.

The facility is maintained at a comfortable temperature. The hot water temperature measures 108.8 Fahrenheit degrees in residents’ restrooms. Restrooms are equipped with required safety measures such as non-skid mats and grab bars Lighting is sufficient to ensure safety and comfort. The facility provides personal hygiene items such as soap, toilet paper, toothbrush, and toothpaste.

The facility has an available a clean supply of linen. LPA inspected resident’s bedroom which had sufficient lighting to ensure safety and comfort. Storage space is provided for resident. Smoke detectors and alarms were tested and operational.