Facility Evaluation Report

On 5/3/24 Licensing Program Analyst (LPA) Javina George conducted an unannounced annual/1 year required visit. LPA was granted entry by caregiver Elisa Dabu, who was informed of the purpose of the visit. The Assistant Administrator Ivy Kasko arrived 30 minutes after LPAs arrival. At the time of the visit there was (3) staff and (0) residents present. All staff present were observed to have obtained proper fingerprint clearance and were associated to the facility. LPA observed the following during today's visit:

The facility is a two (2) story home with (8) bedrooms and (4) bathrooms with attached garage. The facility was observed to be clean and clutter free. On the first floor of the facility there is a total of 3 resident bedrooms, (2 individual and 1 shared). The water temperature was checked in the resident bathrooms and was found to be within regulatory limits as it measured at 112. degrees F.

The second story of the facility is designated for staff, as there is a total of 5 bedrooms, which is also reflected the posted facility sketch that is on file. The exterior-backyard area was observed to be free of hazards. The sharp and dangerous objects were observed to be locked and inaccessible to residents in care as they are stored in a locked cabinet in the kitchen next to the water cooler. The facility was observed to have the required 2-day supply of perishable and 7-day supply of non-perishable foods. LPA observed for there to be expired Brussels sprouts and broccoli that was discarded during LPAs visit.

The facility was observed to have fully charged fire extinguishers. The emergency disaster drills are being conducted on a quarterly basis and the last drill was conducted on 3/19/24. The combined smoke and carbon monoxide detectors were tested and were observed to be operable. There are no known guns or ammunition on the premises. There are no pools or bodies of water.

Resident medication was observed to be locked in armor style cabinet in the hallway. LPA reviewed resident medications for all 4 and observed for the medication to be given according to the physicians instructions .