Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted an unannounced annual inspection visit, and met with Administrator (ADM) Brian Brownell.

1 resident and 4 staff were observed in the facility. License, Administrator Certificate, and personal rights posters were observed in the facility.

LPA reviewed 3 resident files and 3 staff files.

LPA toured the facility inside out with ADM. Living room, one office, family room, kitchen, dinning room and three restrooms were inspected. Two single resident bedrooms, two shared resident bedrooms, and laundry area were inspected. One staff live-in room was observed in facility. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient. Medication closet, knives closet, and cleaning product closet were observed locked. Room temperature was at 77 degree F, and hot water temperature was at 108 degree F in facility. The temperature of the refrigerator was at 40 degree F, and the temperature of the freezer was at 0 degree F.

Emergency light system, first aid box and flash lights were observed at the facility. The last time the facility conducted the emergency drill is 7/9/2024.

Fire extinguisher was serviced on 6/3/2024. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Smoke detectors was tested by staff, and were working fine. Front yard and backyard were inspected. There was no obstruction to block the walkways.

No deficiency was noted today. Exit interview was conducted with ADM. This report was provided to ADM for signature.