Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with Administrator (ADM) Ganiyu Ajani. LPA toured the facility inside and out with ADM. License, Administrator Certificate, and personal rights posters were observed in the facility. 3 residents and 3 staff were observed in the facility. 1 resident went to day program, 1 resident was in hospital, and 1 resident went to doctor appointment.

LPA reviewed 3 resident file and 3 staff files. Family room, kitchen, dining area, 2 restrooms, and garage were inspected. 2 single resident bedrooms, 2 shared resident bedrooms, and 2 staff rooms, a activity are and a office area were inspected. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. Medication closet, knives closet, and chemical closet were observed locked. Room temperature was at 69 degree F, and hot water temperature was at 110 degree F in facility. The temperature of the refrigerator was at 40 degree F. The temperature of the freezer was at 0 degree F.

Fire extinguisher was serviced on 12/19/2024. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Carbon monoxide detectors were tested by ADM, and were working fine. First aid box, and flash lights were observed in the facility. Front yard and backyard were inspected. There was no obstruction to block the walkways. A storage room was observed at backyard. The last time the facility conducted the emergency and fire drill was on 4/10/2025.

No citation noted today. Exit interview was conducted with ADM. This report was provided to ADM for signature. A copy of the report was provided to ADM.