Facility Evaluation Report

Licensing Program Analyst (LPA) Kesha Lewis and Licensing Program Manger (LPM) Liza King arrived unannounced to conduct a quarterly visit. LPA met with the caregiver and explained the purpose of the visit.

LPM conducted a tour of the facility and observed grass and bushes overgrown on the exterior of the building blocking walk ways and emergency exits along the exterior. Additionally one of the two gates latches along the side of the house are broken and not easily accessible. An exterior exit door from a residents room to the backyard was propped closed and locked with a 2x4 j ammed underneath the door handle. A seperate e xit from the interior to the exterior was blocked with hoyer lifts and furniture. Spider webs and spiders located along the awnings and in some resident rooms. A tour of the interior revealed v ideo survelillence components located in the living room which have not been approved by the Department. Mold was present in the shower.

During the previous NCC the facility agreed to:

1. Have an Administrator present 40 hrs a week - Admin was not present during todays visit according to telephone he was a dr apt with a client from another facility.

2. Have accessible an updated LIC 500 which was not accessible and was requested however changes need to be made and the licensee reported over the phone that one would be forwarded by 8/15/25.

3. Facility will have available all documents for review on demand by CCL during business hours. During todays visit all records were on the computer however limited availablity to review due to time constraints.

4. Residents records will be complaint with RCFE regulation 87506.however limited availablity to review due to time constraints

5. An LIC 308 would be followed in the event the Admin was not present - the 308 provided identifies a person however that person was not available during todays visit.