Facility Evaluation Report

Licensing Program Analyst (LPA) Hannah Rodgers and Janet Ngallo conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPAs were welcomed by and discussed the purpose of the visit to Head Caregiver Manny Rodriguez. The facility's license shows a maximum capacity of six (6) residents, three (3) of whom may be ambulatory, and three (3) of whom may be non-ambulatory. During today’s inspection there were five (5) residents in care.

LPAs and Head Caregiver Manny Rodriguez toured the interior and exterior of the facility, and inspected each room. Pathways were free of obstruction and slip hazards. Residents bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to clients. LPAs observed five (5) unlabeled daily medication containers that were filled with residents medications poured in advance in a locked cabinet located in the kitchen. The medications in the daily containers were not in its originally received container and had been transferred from their originally received container. No pools or bodies of water exist on the premises. Per Head Caregiver Manny Rodriguez, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility.