Facility Evaluation Report

Licensing Program Analyst (LPA) Janet Ngallo conducted an unannounced, required Annual Inspection. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to Administrator Susan Caccam. The facility is approved for a capacity of forty-five (45) non-ambulatory residents, all of which may be bedridden. The facility also has a hospice waiver for twenty (20). During today’s inspection there were thirty-eight (38) residents in care.

LPA and Administrator Caccam toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Hot water temperature at taps accessible to residents were compliant. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment.

The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility contained at least two (2) days of perishable food, and at least seven (7) days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present.

No toxic chemicals or poisons were accessible to clients. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per Administrator Caccam, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguishers were serviced within the last 12 months. First aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility. [Continued on LIC 809-C]