Facility Evaluation Report

On 10/25/2022, Licensing Program Analyst (LPA), Murial Han met with the Administrator, Susan Tilma and conducted an unannounced Pre-Licensing inspection.

LPA observed the indoor and the outdoor passageways are free of obstruction.

LPA toured facility and grounds. This is a single level facility. The facility has 6 private resident rooms, 3 staff rooms, 2 resident bathrooms, 1 visitor bathroom and 1 staff bathroom. There is 5 residents during the time of the inspection. LPA observed good lighting and comfortable temperature in the facility. The living room and the dining room is observed to be comfortable, spacious with adequate furniture. LPA observed sufficient hygiene and cleaning supplies. The refrigerator was measured at 35 degrees Fahrenheit (F) and the freezer was measured at 0 degrees F. Dry goods/emergency food supplies are stored in the garage..

LPA observed COVID-19 signs posted by the entrance, within the facility, hand washing instruction signs by the hand washing stations and other postings such as the Licensing Complaint Poster, Resident Rights, etc.

Pre-Licensing is incomplete during this inspection due to the following observations:

- Medication is stored at a centralized area, however, it was not properly locked

- Chemicals, disinfectants, cleaning solutions, etc. are not properly locked

- The facility did not have a thermometer to measure the hot water temperature