Facility Evaluation Report

03/13/2025 10:45 am Licensing Program Analysts (LPAs) Kayla Adkison and Sarah Benson arrived at the facility unannounced to conduct a Required-1 Year inspection. LPAs met with administrator Chaylene Victorine (cert #7008757735 exp.01/28/2026) and explained the purpose of the visit. Administrator certificate is current.

LPAs and administrator toured the facility together to ensure the health and safety of residents in care. Areas toured include but are not limited to four (4) resident rooms, common areas, two (2) bathrooms, kitchen, garage, laundry room, and back yard. In the areas toured no immediate health, safety, or personal rights violations were observed. Staff and resident files were reviewed. Medications were also reviewed. Medication is locked in a locked cabinet.

The common area was clean, odor-free and in good repair. All bedrooms had required furniture, bedding, and lighting. The bathrooms were clean and in good repair. The kitchen was clean and in good repair. Cooking/dining equipment and utensils were present. Food appears to be stored and prepared properly. Facility has required (7) seven-day non-perishable and (2) day perishable supply of food.

The facility was observed to be at a comfortable temperature. Fire extinguisher fully charged. Smoke detectors are all operational. Hot water temperature measured within required Title 22 regulations of 105 degrees F and 120 degrees F. All employees requiring background checks are cleared. There is a schedule of activities planned for the clients. All required postings are displayed within the facility.

No pools/bodies of water are on the premises. No firearms are on premises. The last disaster drill was conducted and documented on 12/28/24, the facility has been conducting drills every 3 months.

LPA interviewed one of one resident and one staff.

Citations were issued. Exit interview conducted and copy of report and appeal rights were provided to administrator. See attached 809-D.