Facility Evaluation Report

Licensing Program Analyst, Amber Coleman, (LPA) arrived at the Nissi House, Adult Residential Facility unannounced to conduct the facility's Annual Inspection. LPA was greeted and granted entry by Caregiver/Staff, Kevin. LPA singed in and was provided a space to work. Kevin Hurd accompanied LPA on a tour of the facility's interior and exterior.

The facility is comprised of 4 Bedrooms, 2 Bathrooms, Living Room, Dining Area, Kitchen, Backyard and attached garage. The facility is vendorized by the Inland Regional Center, designated Level 4I. Caregiver, reports there are two, (2) residents present and 1 resident out for the day with staff.

Physical Plant: The facility is licensed for four, (4) ambulatory adults. The facility is operating in the capacity approved by Community Care Licensing (CCL). Pathways interior and exterior were clutter free and unobstructed. The facility is maintained at 73 degrees temperature. The facility is equipped with functional smoke detectors and carbon monoxide alarms. Extra linens, hygiene supplies, toilet paper and towels were found in a hallway closet in sufficient amounts. Night-lights plugged up along the hallways provide sufficient lighting. Administrator reports fire/disaster drills are conducted twice a year along with the Facility Manager.

LPA observed resident rooms, each room included the regulated bed with linens, sufficient storage, furniture, lighting and seating. LPA observed sufficient furniture and adequate seating in the living and dining rooms. The hot water temperature tested and found within regulation. LPA observed posters for resident rights, Long Term Care Ombudsman, licensing documents, LET-US-KNOW and Infection Control, Resident/Staff Roasters posted in common areas of the facility. Cleaning supplies, toxins, sharps, and other dangerous items were kept secure under the kitchen sink and attached garage - inaccessible to residents. The resident's medication records and medications are kept secure in a cabinet next to the kitchen. Resident, Facility and Staff files are kept secure here as well.