Facility Evaluation Report

Licensing Program Analyst (LPA) Crystal Colvin arrived at the facility for the purpose of conducting a second Pre-Licensing visit. LPA Colvin met with Administrator Jones Ntekim and Licensee representative Theresa Bader. The facility is currently in operation under another license and is undergoing a change of ownership.

The building is equipped with 28 bedrooms, 4 common bathrooms accessible to residents (in addition to multiple resident bedrooms equipped with personal bathrooms), common areas, medication room, staff offices and break rooms, dining room and kitchen. Per the approved fire clearance, the licensee is approved for 49 ambulatory residents. LPA Colvin observed resident bedrooms to be furnished with the required items such as dressers, night stands, and beds. The facility has adequate quantity of linens, towels and hygiene products for residents. LPA Colvin measured the hot water in one of the common bathrooms and observed it to read at 114.8 degrees. The smoke and carbon monoxide alarms were tested on 10/12/21 by the Fire Marshall, and are equipped to notify the local Fire Department immediately upon signal. LPA observed fire doors to be properly functioning. Fire extinguishers are present in the facility and fully charged.

The kitchen was observed to have dishes, silverware, pots, and pans. LPA Colvin observed the temperature of the freezers in the kitchen to be reading at 14 degrees and the refrigerators to be reading at 34 degrees. All appliances are operational, and the facility has sufficient amount of both perishable and non-perishable food, and LPA Colvin additionally observed the facility to be receiving a food delivery during LPA Colvin's inspection. Knives and potentially harmful chemicals are generally locked and out of reach of residents in storage. Laundry facilities are available for residents to use with staff assistance, as well as additional lcoked laundry facilities for staff to clean residents' linen. Staff and resident files will be locked in a file cabinet in the office.

Medications are locked in the medication room, which is staffed and secured beyond another office.LPA Colvin observed a miniature refrigerator in the medication room as well, which is operational.