Facility Evaluation Report

On 02/25/2025 at 02:15 PM, Licensing Program Analyst (LPA) Melody Brown made an unannounced visit to the facility. The purpose of the visit was to conduct the required comprehensive annual inspection. LPA Brown met with a staff and was granted entry to the facility. At the time of the visit there were one (1) staff present, and four (4) residents present. Licensee/Administrator Mercillina Ajunwa was contacted and informed of the visit. Licensee/Administrator Ajunwa arrived during the visit. LPA Brown explained the purpose of the visit to Licensee/Administrator Ajunwa.

The facility has 6 bedrooms, in which five (5) bedrooms are designated for residents, and one (1) bedroom's designated for staff, 3 and 1/2 bathrooms, living room, kitchen, dining area, backyard, laundry room and attached garage. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for a capacity of six (6) non-ambulatory residents, one (1) resident may be bedridden. The current census is four (4) residents. The facility has approved hospice waiver for four (4) residents. LPA Brown was accompanied by Staff #2 (S2) to conduct a general overall inspection, which included, but was not limited to, the following:

Physical Plant : The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). The buildings and grounds were free from hazards. Outdoor and indoor passageways were kept free of obstruction. The facility is maintained at a comfortable temperature of 68 degrees Fahrenheit. LPA Brown inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA Brown observed sufficient furniture and lighting throughout the facility. LPA Brown measured and observed the water temperature in the residents/staffs shared bathroom to be at 105.2 degrees F. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Postings such as the facility license, personal rights, the CCLD complaint poster, ombudsman poster, labor laws, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. Medications are kept inside the medication closet ***Continuation in LIC809C***