Facility Evaluation Report

Licensing Program Analyst (LPA) Jerome Haley conducted an unannounced visit for the purpose of conducting a required one-year annual inspection. LPA was greeted, granted entry by staff and explained the reason for the visit.

The facility is a single level structure and licensed for six non-ambulatory residents; of which, one may be bedridden. The facility is full at the moment with six residents admitted. All residents were present during the visit. There’s a total of 6 bedrooms and 4 bathroom areas. There’s a living room space, a dining space, backyard, and a detached garage. Bedrooms: All bedrooms have the required furnishings: bed, lamp, chair, and storage space. Bathroom(s): Bathrooms are equipped with a working toilet, wash basin, and shower. Hot water measured in between 108.5 – 109.5 degrees F. Kitchen: 4 of 4 burners and the warmer are operational on the gas stove. Sharps are kept locked in a kitchen drawer across from the sink. Cleaning chemicals are stored below the sink in a locked cabinet. Food Service: A supply of perishable and non-perishable food supply that meet regulation requirements was observed.

Client & Staff Files : Resident and staff files stored in locked filing cabinets near a dining table below the facility postings board.

File Review: 3 of 6 resident files were reviewed during the visit, and 3 staff files were reviewed.

Medications/First-Aid Kit: Resident medications and the first aid kit are stored in the locked filing cabinets near the dining table.

Medication Review: 3 of 6 resident medications were reviewed during the visit. Medication is being administered as prescribed. No discrepancies were noted.