Facility Evaluation Report

Licensing Program Analyst (LPA) Victoria Brown arrived unannounced to conduct a Required - 1 Year visit on 7/15/24 at 1:30pm. Administrator certificate expires 9/2/25.

LPA met with Tinh Nguyen, Caregiver and stated the purpose of todays visit. Administrator arrived to assist with todays visit.

The facility is licensed for a capacity of 4 ambulatory of which 1 maybe non-ambulatory.

LPA toured and inspected the physical plant inside and outside to ensure there are no safety hazards to residents.

The temperature inside the facility was observed to be at 73*F which is within the required range of 68-85*F.

The hot water temperature was measured at 106.8*F which is within the required range of 105-120*F.

LPA observed fire extinguisher(s), smoke and carbon monoxide detectors, and central heating and air in the facility.

LPA observed the centrally stored medications area to be locked and inaccessible to residents.

LPA observed 3 residents and 1 staff file for staff and clients during this visit.

LPA did observed 2-day perishables and 7-day non-perishables.