Facility Evaluation Report

Licensing Program Analyst (LPA) William Vanegas conducted an unannounced inspection for the purposes of completing an annual inspection. Upon arrival LPA Vanegas was greeted and granted entry to the facility by Administrator (AD) Nellie Mai Caudle. LPA Vanegas explained the purpose of the inspection and being a tour of the facility

LPA Vanegas observed the following. This is a one storied house with four bedrooms, and two bathrooms. There is an attached two car garage, and a large backyard in the facility. LPA Vanegas observed the kitchen area to be clean and free of any debris. LPA Vanegas observed a seven day supply of non-perishable foods, and a two day supply of perishable foods LPA Vanegas also observed a sufficient amount of emergency water.

LPA Vanegas observed an electric stove, refrigerator, microwave, dishwasher, washer, and dryer that all appeared in good repair, and tested operational. LPA Vanegas observed all fire extinguishers to be fully charge and up to date. LPA Vanegas observed smoke and carbon monoxide detectors to be in good repair and operational.

LPA Vanegas observed all resident rooms to be clean and free of any debris. LPA Vanegas observed all resident rooms to have required furnishings such as chest drawers, a bed, clean linens in good repair; meaning no strains or tears, enough storage space to store personal belongings, and a reading lamp.

LPA Vanegas observed resident bathrooms to have all required furnishings such as a shower chair, slip resistant floor matts, and grab bars. Water faucets and toilets tested operational. Water temperature tested between 112.8 and 113.0 degrees. CONTINUED ON LIC809C