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 Front Desk Staff Ahdiyeh Dargahi. Executive Director Denise Notter arrived later during the visit. The facility's license shows a maximum capacity of sixty (60) residents, fifteen (15) of which may be bedridden. The facility is approved for delayed egress and secured perimeter, and additionally has a hospice waiver for twenty (20). During today’s inspection there were forty-nine (49) residents in care.

LPA and Executive Director Notter toured the interior and exterior of the facility and inspected a number of resident rooms. 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: Bathroom sink in one resident unit was 108F. Extra linens and hygiene supplies were present, as well as multiple stores of 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.