Facility Evaluation Report

Licensing Program Analyst (LPA) Michelle Echeverria arrived unannounced to conduct the required annual visit to the facility. LPA met with Staff (Pending Licensee/Administrator), Faryal Khan and introduced self and stated purpose of the visit. LPA was informed that there are currently 6 residents in care who are in the facility.

The facility has (6) resident bedrooms, (3) resident bathrooms, living room, dining area, kitchen, backyard, and attached garage. LPA completed a walk through of facility and review of records.

Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 76 degrees fahrenheit. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, chairs and sufficient lighting. LPA inspected resident bathrooms; bathrooms were clean and appliances were found functional. LPA observed grab bar missing from the toilet in one bathroom. Deficiency issued. LPA observed insufficient hygiene products for residents. Deficiency issued. Water temperatures tested at 115.7 degrees fahrenheit. The facility is equipped with operational smoke detectors, carbon monoxide alarms, fire extinguisher and first aid kit. Posters such as; the personal rights, ombudsman and emergency disaster plans were posted in a common area. There was a designated storage space for resident/staff files. Resident medications were observed secured and inaccessible to residents. LPA observed accessible staff's cough medicine in the kitchen cabinet and chemicals in the resident's bathroom cabinet. Deficiency issued. There are no guns, ammunition, swimming pool or bodies of water in the facility. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care.

Food Service : Non-perishable and perishable food supply is not sufficient for number of residents in care. Deficiency issued. Dishes, cups, and utensils were also stored properly.