Facility Evaluation Report

Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a required annual inspection. LPA met with Anchalee Phumirat , Licensee and discussed the purpose of the visit.

The facility is a Residential Care Facility for the Elderly (RCFE). License capacity of (6) with a current census of (6) residents. Hospice waiver for (6). LPA conducted an overall inspection of the facility, which included, but was not limited to, the following:

LPA inspected the facility inside and out. Indoor and outdoor passageways are free of obstruction. The facility has sufficient lighting and is maintained at a comfortable temperature. Fireplace is adequately screened . Backyard has a swimming pool which is empty and secured with a locked fence, inaccessible to residents in care. Facility has a covered outdoor patio area and self-latching backyard gate.

LPA inspected the kitchen. The facility has three (3) refrigerators which tested between 33 to 43 degrees F. Kitchen hot water temperature is maintained at 111 degrees F. Facility has sufficient non-perishable and perishable food supply for the number of residents in care. Facility has sufficient cups, plates, and utensils for resident use.

LPA inspected resident bedrooms. Bedrooms are equipped with mattresses, nightstands, pillows, chairs, and storage space. Bedrooms have sufficient linen and lighting.