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.

6 residents and 7 staff were observed in the facility. LPA reviewed 3 resident file and 3 staff files.

Living room, kitchen, dining room, restrooms, and laundry rooms were inspected. 2 single resident bedrooms, 2 shared resident bedrooms, and offices were inspected. one staff room in the first floor and 3 staff rooms at the second floor were observed. 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 112 degree F in facility. The temperature of the refrigerator was at 20 degree F, and the temperature of the freezer was at 0 degree F.

Fire extinguisher was serviced on 12/12/2023. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Smoke 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.

ADM stated the last time the facility conducted the emergency and fire drill was on 4/28/2024.

Deficiencies were noted today. See LIC809-D. Exit interview was conducted with ADM. This report was provided to ADM for signature. A copy of the report was provided to ADM.