Facility Evaluation Report

Licensing Program Analyst (LPA) Bianca Wolcott arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by Rustan Lladones (Administrator) and granted entry. LPA began inspection with introduction, visit purpose and provided the facility caregiver with LPA identification and business card. The facility has 5 bedrooms, 2 rooms are staff, 2 bathrooms, kitchen, dining area, living room, laundry room, attached garage, and backyard. LPA completed a walk through of the facility and review of records.

Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. LPAs observed the facility to be clean and in good repair. The home is maintained at a comfortable temperature for the residents. Lighting is sufficient for safety and comfort. Water temperature measured 107 within range. Grab bar near the shower. LPAs observed a locked drawer with sharps. LPA observed a locked hallway closet with medications and staff and resident books.

Fire extinguishers are charged, mounted. All outdoor and indoor passageways are free of obstruction. Night lights and emergency lighting is present. There is a telephone working at this location. The emergency disaster plan is maintained. Emergency Drills and Fire Drills are being maintained. The facility has a current written definitive plan of operation. The facility is maintained in conformity with the regulations adopted by the state fire marshal. P&I was accessed and verified by Administrator. Refrigerator is 40 degrees, and freezer is -0 degrees.

Personnel Records/Training/and Staffing-. LPA reviewed employee record for first aid certification, fingerprint clearance, personnel/job application, health screening and TB test results, criminal record statement, employee rights, training verification, and current administrator certification. LPA observed First Aid Book available at facility.