Facility Evaluation Report

Licensing Program Analyst (LPA) made an unannounced visit to conduct the required annual inspection. LPA was greeted and granted entry by staff. LPA met with Administrator Julie Gorordo and explained the reason for the visit. LPA and Administrator toured the facility. The facility is a 5 bedroom house one story house with a kitchen, dining room, 2 bathrooms and a 2 car garage that is used for storage and kept locked. LPA and Administrator toured the facility. LPA observed the See Something Say Something Poster (PUB 475) in the entrance way of the facility. LPA observed both bathrooms are clean and operational. Hot water measured 116.4 degrees Fahrenheit in bathroom 1 and 115.4 degrees Fahrenheit in bathroom 2. LPA observed a two day perishable and a 7 day perishable food supply in the kitchen. The stove lights unassisted. The fire extinguisher in the kitchen if fully charged. LPA observed all medications are kept locked in the kitchen cabinet. Knives are kept locked in a kitchen drawer. LPA observed the kitchen is clean and organized. LPA observed all resident rooms had the required furnishings. LPA observed all 4 residents had half bed rails. LPA reviewed all 4 resident files and observed each resident had a sign physician's order for half bed rails. All 4 resident files had the required documents. LPA toured the backyard. No bodies of water observed. The exit gate is latched and operational. There is a table with 6 chairs and an umbrella in the backyard for residents to sit outside. The backyard is completed paved with planters on the edges next to the fence. The planters have bushes and trees. No obstacles or hazards observed in the backyard. LPA observed the garage is used for storage and has old furniture and supples. The detached garage is kept locked and inaccessible to residents. LPA reviewed 4 staff files. All 4 staff members had the required training. All 4 staff files had the required documents. LPA reviewed all 4 resident medications and medication administration records (MARs). No discrepancies observed. Smoke/carbon monoxide detectors tested operational. LPA inspected the first aid kit. The first aid kit has all the required elements. LPA interviewed 2 residents and 1 staff. No deficiencies observed during the visit. No deficiencies are being cited as a result of this visit. An exit interview was conducted and a copy of the report provided.