Facility Evaluation Report

Licensing Program Analyst (LPA) David Marrufo conducted an unannounced Required - 1 Year visit and met with Administrator Jolene Sicley.

During visit, LPA Marrufo toured the facility inside and out. LPA toured three out of three facility kitchens. The kitchens had a perishable food supply of at least two days and a non-perishable food supply of at least three days.

LPA toured 12 out of 49 resident apartments. Each apartment had working lights and available bedding and clothing storage areas.

LPA toured 12 resident bathrooms. The water temperatures in the bathrooms ranged from 88 F to 126 F. Eight out of the twelve inspected bathrooms had water temperatures that were below 105 F or above 120 F. Each bathroom had working lights and available soap and paper towels.

LPA toured the outside area and observed the exits to be clear of obstructions.

During visit, facility staff tested the smoke detection system and it functioned properly when tested.

LPA Marrufo reviewed 6 resident records, including Centrally Stored Medication and Destruction Records, and found them to be complete. LPA reviewed 6 staff records. See LIC809-C for more information. Page 1 of 2.