Facility Evaluation Report

On 6/1/2023, Licensing Program Analyst(LPA) Murial Han conducted an unannounced annual inspection. LPA was greeted by caregiver, Maribel Vega. LPA explained the purpose of the visit. Ms. Vega called administrator, Myron Bolden who arrived later to assisted with the inspection.

Ms. Vega provided a tour of the facility and LPA observed the 4 bedrooms (2 private rooms and 2 shared rooms), 2 full- bathrooms, kitchen, and common areas. The facility observed to clean, tidy and in good repair. Bedrooms were equipped with the required furniture for residents to use. Bathrooms are equipped with grab bars, and nonskid mats. Facility has recently installed the digital and key locks on each resident's doors to promote privacy. Facility temperature is comfortable at 72 degrees F. Hot water temperature was measured at 106- 110 degrees F.

Central stored medication, toxins and sharps objects were locked and inaccessible to residents.

Staff files and training records were reviewed; food supplies were observed to be adequate.

Based on the emergency drill records, it revealed that the latest ones were completed on July 15, 2021 and April 29, 2023.

Facility is equipped with smoke detectors and carbon monoxide detectors. Fire extinguisher was last serviced July 2, 2021.

Staff members at the facility were fingerprint cleared and associated to the facility.

LPAs reviewed resident records that contain admission agreement, medical assessment, LIC 602 (Physician Order), Appraisal Needs and Service Plan, GGRC/IPP.