Facility Evaluation Report

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the purpose of the visit. Administrator Muhammad Saeed was present on the premises and assisted with the visit.

There are currently three residents in care, all of which are receiving hospice care at this time. Residents are observed relaxing in the facility's common areas or in their respective bedrooms. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with two private and two shared bedrooms for use by residents. There are two shared bathrooms used by residents, one of which is en-suite. None of the residents are bedridden at this time.

All occupied bedrooms appear clean and sanitary. All three residents use full-length rails for postural support. Adequate physician orders and hospice plans of care reviewed and on file. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary and are all equipped with grab bars and slip mats. Hot water temperature measured at 106F at two separate sinks used for personal grooming.

LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items, cleaning supplies and the medication central storage are verified to be secure.

The two fire extinguishers present are verified to be charged with up-to-date maintenance tags. Carbon monoxide and smoke detectors were found to be present and operational. Emergency food is present in the pantry and emergency water supplies are stored in the garage.