Facility Evaluation Report

Licensing Program Analyst (LPA) Andrew Martinez made an unannounced visit to the facility to conduct a required comprehensive annual inspection. LPA met with Administrator Jennifer Hahn, and discussed the purpose of the visit. LPA conducted a general inspection walk through of facility with Administrator Hahn, which included, but was not limited to, the following:

Physical Plant: The facility is a single-story (5) bedroom , (3) bathroom Residential Care Facility for Elderly (RCFE) home operating in approved licensed capacity by the Community Care Licensing Division (CCLD), with a current census of (6). The facility has no swimming pools or similar bodies of water. The facility is equipped with sufficient indoor and outdoor space and seating for resident activities; all indoor and outdoor passageways were kept free of obstruction. The facility indoor tem perature was maintained at 75 degrees Fahrenheit. Cleaning supplies, toxins, and sharps were kept locked and inaccessible to residents in care.

Bedrooms: Resident bedrooms were furnished with mattresses, night stands, chairs, storage space, and sufficient lighting. No resident bedrooms is a passageway to another bedroom.

Bathrooms: Resident bathrooms were maintained clean and fixtures were operating properly. H ot water temperatures in the bathrooms was measured at 115 degrees Fahrenheit. Restrooms were equipped with grab rails and slip mats.

Food Service: Kitchen and dining areas were maintained cleaned. Non-perishable and perishable food supply is sufficient for number of residents in care. Facility refrigerators and freezers were maintained in healthful manner.