Facility Evaluation Report

Licensing Program Analyst (LPA) Jenny Olson arrived unannounced to conduct a one year required annual visit. The LPA met with Licensee/Administrator Carol Gantous and explained the reason for the visit.

LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

Kitchen: The facility has a sufficient supply of non-perishable and perishable food items. Cleaning supplies and disinfectants are stored under the sink. Knives are stored in a cabinet in the kitchen.

Common areas: Living and dining room furniture were observed to be in good condition. At 12:00 p.m., smoke detector(s) and carbon monoxide detector were tested and operational at the time of the visit. The fire extinguisher was charged and serviced recently. The hot water temperature measured at 118.9 degrees Fahrenheit.

The backyard has an area equipped with furniture for client use. No bodies of water noted. The washer and dryer are in the garage. The garage is not locked.

Restrooms: The client restroom was clean and sanitary and in operating condition with non-skid surface mat. The bathroom was sufficiently stocked with soap and paper towels.

Bedrooms: There is one (1) client bedroom, which was furnished with appropriate linens and required furniture. A linen closet was located outside of the room which was stocked extra linens and towels.

Records: The LPA reviewed client and staff records at 11:00 a.m. LPA reviewed one (1) client file for, but not limited to, the following: signed admission agreements, medical assessments with TB results, and current needs and services plan. All files were complete.