Facility Evaluation Report

Licensing Program Analyst (LPA) Rankin arrived at 10:16 am to conduct a 1-year annual visit to the facility above. LPA met Administrator Edwin Ingan and explained the purpose of the visit.

A tour of the inside and outside of the facility was conducted with Administrator. The following was inspected and noted during the annual visit:

Infection Control: The facility has enough PPE for 30 plus days, The facility trains on infection control and PPE. Meal and medication can be delivered to rooms if a resident is in need of isolation.

Physical Plant & Environmental Safety: The facility has 3 bedrooms and 2 bathrooms currently occupying 6 residents and employs 5 staff. The facility is clean, safe, and sanitary. LPA was authorized to enter and inspect facility. The facility has a smoke alarms and the carbon monoxide detector were tested and working. The lighting and lamps are sufficient for the use of the facility and for resident comfort. The facility kitchen is clean, safe, and sanitary. The showers have non-skids flooring ormats. Toilet, hand washing and bathing facilities are operational and secured grab bars are present. The pathways are clear of any obstructions. Facility is well lit inside and outside for safety. Disinfectant, cleaning solutions and poisons are inaccessible to residents and locked in garage. The facility has sufficient space inside and outside for activities and visiting. The facility has a backyard and front yard for resident use with shade. The facility has telephone and internet service for resident use. The facility provides resident with a shared tablet for access internet.

Operational Requirements: The facility has current liability insurance and expires on 10/28/2025. The facility is approved for a capacity of 6 non-ambulatory of which 1 may be bedridden, and Hospice approved for 3 residents.