Facility Evaluation Report

Licensing Program Analyst (LPA), Robert Campbell made an unannounced visit to the facility to conduct a required annual inspection. LPA was greeted and granted entry by Anissa Rivas/Assistant Program Director who was informed of the purpose of the visit. At the time of visit there was eleven (11) staff and sixteen (16) residents present.

The facility is one story and has eight (8) bedrooms that are shared, up to two (2) clients to a room. LPA conducted a general overall inspection, which included, but was not limited to, the following: physical plant; interior and exterior, and records review. LPA was not able to review staff files due to the documentation being at another location and staff could not get access to them. LPA issued a TypeB deficiency that is documented on LIC809D form.

The facility appears clean and free of odors. LPA observed that the facility did not have any health and safety issues. Staff present have criminal record clearances and are appropriately associated to the facility. Client bedrooms are clean and appropriately furnished. Food and emergency supplies are sufficient. LPA observed all toxic chemicals and other hazards secured and inaccessible to clients. Medications are centrally stored in a locked cabinet in the nurse's office. Hot water was tested at 112 degrees Fahrenheit. Furniture in the facility is in good repair. Outdoor space is free of hazards. Smoke alarms are in working order. Fire extinguishers were examined to be up to date. The facility is completing emergency drills on a monthly basis.

LPA inspected medications and medications appear to be dispensed appropriately according to physician's orders. Dues are current.

An exit interview was conducted and a copy of the report was provided.