Facility Evaluation Report

Licensing Program Analyst (LPA) Steve Chang conducted a unannounced annual inspection visit and met with Licensee Pam Sloan (LNS) and administrator (ADM) Armand Galleon.

LPAs checked 5 resident record files (R1 - R5) and 5 staff record files (S1 - S5).

LPA toured the facility inside out with LNS. LPA inspected living room, kitchen, dinning area, and laundry room. Medication closet, knives closet, and cleaning product closet were observed locked.

There are 3 shared resident rooms at first floor for residents, and 2 restrooms at first floor. There is 1 staff live-in rooms in the first floor and 1 staff live-in room at the second floor in facility. One office was observed at the facility. Room temperature was observed at 70 degree F, and hot water temperature was observed at 110 degree F. The temperature of refrigerator was observed at 40 degree F, and the temperature of the freezer was observed at 0 degree F. Two day perishable food supplies and seven day nonperishable food supplies were observed sufficient.

The facility is equipped with smoke and carbon monoxide detectors. The facility equipped with fire alarm system. LNS tested the smoke and carbon monoxide detectors, and they were working fine. The fire extinguishers were observed on service on 06/14/2023. LPA inspected the backyard, there was no obstruction to block the walkway. There is a detached garage at the facility.

Exit interview was conducted with LNS. LIC9099-D and Appeal Rights were attached. The reports were provided to LNS for signature. A copy of this report was provided to LNS.