Facility Evaluation Report

Licensing Program Analyst (LPA)Manuel Monter and Licensing Program Analyst Steve Chang conducted an unannounced Required 1 Year visit and met with Licensee Fred Ogle.

LPAs toured the facility inside and out. LPAs toured the facility in the following area: resident/staff bedrooms, kitchen, hallway free from obstructions, living and dining area. Food supplies were also inspected for both 7 days non-perishable and 2 days perishables. Facility first aid kit was observed and met the requirement. Toxic materials and sharp or hazardous objects were observed inaccessible to residents in care. The facility had toiletries. There are two bathrooms/shower with grab bars and skid mats. The facility hot water temperatures in the following areas are measured with thermometer. The temperature varies from 106.1-109 degrees F.

Facility smoke detectors including carbon monoxides were observed and tested and found to be functioning. The facility yard was inspected and no tripping hazards or hazardous items observed during inspection.The facility fire extinguisher was also inspected and did not have a tag indicating when it was last inspected. Licensee bought fire extinguisher during visit.

During inspection of the facility, LPA's observed a storage unit in the backyard; its was only being used as storage.

LPA's did not observe facility records for staff and residents due to Licensee stating they could not find the documents. LPA reviewed resident medications and centrally stored medication records for 4 residents. LPA conducted interviews with 1 staff (S1) and 4 residents. Licensee stated that the facility does not handle cash resources.

During today's inspection Technical Violation (TV) and deficiencies were issued. See LIC9102 and lic809d.

This report was reviewed with Licensee Fred Ogl. A copy of this report was provided during exit interview.