Facility Evaluation Report

On December 16, 2024, at 9:15 AM, Licensing Program Analyst (LPA) Kiran Jain arrived unannounced at the facility to conduct a Required 1-Year Annual inspection. LPA met with the Administrator, Betty Jean Jaurique and disclosed the purpose of the inspection. The administrator informed the LPA that the facility currently has 5 residents in care, Level 3, and all 5 are ambulatory. (4) Residents were away at their day program and (1) resident was at home sick.

At 9:20 AM, the LPA initiated a walk-through of the facility, accompanied by the administrator.

LPA inspected the kitchen and found it clean, with no food preparation or cooking in progress at the time. LPA checked the appliances and observed them in working order. LPA inspected the refrigerator and pantry cabinets and observed enough supplies of fresh perishable food for (2) days and nonperishable staples for (7) days. No expired food and no stored medications were noticed.

At 9:24 AM, LPA observed knifes, bleach solutions, comet bleach, disinfectants, and cleaning chemicals in an unlocked closet underneath the kitchen sink and accessible to residents in care.

LPA inspected the den area and observed it clean. There was a fireplace with a screen cover, sofa chairs and computer workstation. There was a dining area next to the den and found it clean containing a dining table, and dining chairs to accommodate all the residents. LPA inspected the family room and observed it clean, with all the furniture in good repair. There was a sofa set, chairs, TV, and a Christmas tree.

LPA inspected the fire extinguisher mounted on the wall next to the dining area and found it fully charged with a last service tag of 04/09/2024. The administrator tested the smoke and carbon monoxide detector located in the hallway in the LPA's presence, and it was found to be functional. Additional smoke and carbon monoxide detectors were observed in all bedrooms and common areas of the facility during the visit.