Facility Evaluation Report

Licensing Program Analysts (LPA) Marybeth Donovan arrived unannounced to conduct a Pre-Licensing visit. LPA met with Amarvir Nijjar.

There is currently 4 residents living at the facility. The facility has an approved fire clearance for 6 capacity.

LPA toured the facility inside and outside including the entry point, living room, dining room, kitchen, bedrooms, bathrooms, and patio. Resident rooms were equipped with proper furniture and lighting. Bedding and linens are available to the residents and observed to be clean. Bathrooms was equipped with hygiene supplies. Hot water temperature was measured at 107.6 and 106.9 degrees Fahrenheit in hall bathrooms. LPA observed a minimum of 2 day perishable food supply and 7 day nonperishable food supply. Fresh fruit of bananas, apples and cutties were observed. Facility is equipped with cups, plates, utensils, and cooking supplies.

Medications are secured in a locked cabinet in the kitchen. LPA observed first aid kit with the following supplies: bandages, scissors, tweezers, and thermometer.

LPA observed knives, sharp objects, toxins and cleaning supplies in a locked cabinet in the laundry room.

LPA reviewed 2 resident files and 3 staff files. Staff files all consist of Personal Record, Health Screening with TB Information, First Aid Certification and Training.