Facility Evaluation Report

Licensing Program Analyst (LPA)s Hiratsuka and Mikkelson, conducted this announced annual visit. LPAs toured with Caregiver Manoa Namusudroka. Administrator Adilina Tuiloma arrived during visit.

This facility currently has five residents. There are two shared and two private resident rooms. There is one full shared bathroom and one full bathroom in one of the shared resident rooms. A couple of resident rooms have exits to the outside. There is a locked laundry room and a staff room that is located by the kitchen. The dining, common, and kitchen areas were clean during this visit. There are two sheds in the backyard that are used for storage. There is a locked closet for medications and files. There are locked cabinets for cleaning toxins and sharps.

Five of five resident records were reviewed.

Discussed with Administrator is logging of staff training. The staff do have training but some have logs that have dates, times, topics, and the length of time and some just have the training topics with the sheets signed. Staff do have training, but the logs are required to have the dates, times, topics, and length of time.

The front gate was discussed. The gate is able to be opened but it can be difficult. Administrator stated she contacted a maintenance person and landlord about the gate to get it fixed or replaced. LPAs discussed leaving it partially open during the day time hours and close it at night without locking the gate. Resident supervision and audio alerts were discussed.