Facility Evaluation Report

Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required annual inspection. LPA met with Administrator Rozina Amlani and explained the reason for the visit. Facility is licensed for 6 non-ambulatory residents of which 1 may be bedridden. Facility is a single story home with 7 bedrooms (1 is for staff) and 7 bathrooms, kitchen, dining room, living room with a screened fireplace and a two car garage. The garage is used for storage and kept locked. The Administrator's Certificate expires on August 28, 2026. LPA and Administrator toured the facility. LPA observed the See Something Say Something Poster (PUB 475) in the main entry way of the facility. LPA observed the fireplace in the living room is screened. There is a large screen TV in the living room. The Administrator reported the fireplace is not used. LPA observed there is a two day perishable and a seven day non-perishable food supply on hand in the kitchen. Knives are kept locked in a kitchen cabinet. LPA observed the 5 burner gas stove lights unassisted. The fire extinguisher in the kitchen is fully charged. LPA observed all resident rooms had the required furnishings and bed linens. LPA observed all bathrooms are clean and operational. Hot water measured 115.7 degrees Fahrenheit in bathroom number 3 and the bathroom in the hallway. LPA and Administrator toured the garage. The garage is kept locked and used for storage. LPA observed the emergency food and water (3 day supply) stored in the garage. LPA observed the first aid kit has all the required elements. The last emergency drill was conducted on June 5, 2025. Smoke detectors/carbon monoxide detectors tested operational. LPA observed medications are kept locked in the hall closet along with the first aid kit. LPA observed the facility has a dedicated internet device for resident use (tablet). LPA and Administrator toured the backyard. There is a water fountain the backyard. There tables with umbrellas and chairs to sit outside. Both exit gates are operational. No obstacles or hazards observed in the backyard. LPA reviewed 4 resident files and medications, no discrepancies observed. LPA reviewed 2 staff files, both staff members are background cleared and associated to the facility. Both staff members have the required training.