Facility Evaluation Report

Licensing Program Analyst (LPA) Janira Arreola made an unannounced visit in order to conduct a health and safety check. LPA met with administrator John Reade, who was informed of the purpose of the visit. At the time of the visit there were (2) staff and (5) residents present.

LPA proceed to conduct a walk through of the facility. LPA observed that the home was being painted from the outside, and did not observed any active construction in the interior of the home. LPA spoke with administrator who confirmed this, and stated that the home would be painted for the next (3) days. LPA was informed (1) resident was at the hospital during the visit whom had a doctor's appointment. LPA proceeded to observe the facility medications cart and the central entry point. LPA had her temperature taken upon arrival to the facility. LPA walked through the resident rooms and observed the (5) resident, (3) were in the upstairs family room watching tv and reading magazines. (1) resident was seated at the dining table, and (1) resident was in their room.

LPA requested staff file for the administrator and the administrator was unable to provide it at the time of the visit. This will be documented on deficiency page along with the plan of correction. LPA requested resident files, which administrator was unable to provide at the time of the visit. This deficiency will be documented along with the plan of correction. LPA requested the most up to date copy of the LIC500 and LIC9020. Administrator stated that he had these documents but was unable to access it as it was in the facility garage and could not be accessed in a timely manner . This deficiency will be documented along with plan of correction.

An exit interview was conducted where a copy of this report along with LIC 809-D pages and appeal rights were reviewed and provided to administrator, John Reade.