Facility Evaluation Report

On this day, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced required 1 year annual inspection visit. LPA met with co-administrator/staff Kesa Vodonaivalu and explained the purpose of today's visit. LPA asked about the the listed administrator, Suzi Stefanac, and she indicated she is not present on this day but visits the facility multiple times a week.

LPA was allowed entry to the facility. This is a single level facility and is licensed to serve 6 residents all of whom may be non-ambulatory. Facility has a hospice waiver on file for 4 residents. There are no residents on hospice during today's visit according to Kesa. Annual Fees are current. The physical plant is toured inside and outside to ensure the safety of the residents. During today's visit LPA observed 3 of the 4 residents, one of which was still sleeping in bed, and one is at the main dining table having breakfast. LPA observed the facility kitchen which is located adjacent to the dining room. Knives are stored within the kitchen in a drawer adjacent to the sink. Medication cabinet is observed as lockable adjacent and above the counter to the sink. It is unlocked at time of inspection due to staff distributing medications as observed by LPA. Perishable and non-perishable food items are observed as in place in the refrigerator in the kitchen. Additional refrigerator is observed to contain additional food items in the garage. Resident medications are in place and current. The first aid kit is maintained and is complete with required items.