Facility Evaluation Report

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced, required Annual Inspection. The facility file and personnel report was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to Staff Petrada "Alice" Veopradith. Administrator Siera Navasak arrived a few minutes later. The facility's license shows a maximum capacity of six (6) non-ambulatory residents. Additionally, the facility is approved for three (3) hospice waivers. During today’s inspection there were five (5) residents in care with one (1) currently receiving hospice services.

LPA and Administrator Navasak toured the interior and exterior of the facility and inspected each room. Facility sketch was consistent with the current layout of the facility. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Hot water temperature at taps accessible to clients were all compliant: private bathroom sink in a dual occupancy room was 105.3F. 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. Knives were locked and inaccessible to residents in care.