Facility Evaluation Report

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

LPA checked 2 resident record files and 2 staff record files. 2 residents and 3 staff were observed in the facility.

LPA toured the facility inside out with ADM. Facility license, Personal Right posters, and Administrator Certificate were observed in the facility. Living room, family room, kitchen, dinning room and three restrooms were inspected. Six resident bedrooms, and laundry room were inspected. Two staff live-in rooms were 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 70 degree F, and hot water temperature was at 109 degree F in facility. Non skid mats were observed in the bathrooms. The temperature of the refrigerator was at 35 degree F, and the temperature of the freezer was at 0 degree F.

Fire extinguisher was serviced on 4/24/2024. The facility was equipped with fire alarm system, smoke and carbon monoxide detectors. Smoke detectors and carbon monoxide detector was tested by ADM, and was working fine. First aid box, flash lights and night lights were observed in the facility. Front yard and backyard were inspected. There was no obstruction to block the walkways.

The last time the facility conducted the emergency drill is 6/15/2024.

No deficiencies were noted today. Exit interview was conducted with ADM. This report was provided to ADM for signature. A copy of the report was provided to ADM.