Facility Evaluation Report

Licensing Program Analyst (LPA) Jill Nakagawa conducted an unannounced Annual Inspection on 02/23/2023. This inspection is focused on Covid-19 protocols and practices. At the time of inspection there was one resident in the facility who is currently on Hospice. 2 other residents were out at their respective Day Programs. There were two staff.

LPA met with Jenna Baluyot , who is in the process of becoming the Administrator: paperwork to be submitted shortly. The facility is working with Fire Department for bedridden clearance and was installing a new fire door, as per their request. New Facility Sketch and Fire Dept. Notice will be forwarded to CCL directly.

The facility has a paved back yard, with deck and ramp for access to the back bedroom. There is a locked shed for storage as well as a small locked building for staff quarters.

At the time of inspection the house was clean, well-organized and a comfortable temperature. Each resident's room was outfitted according to their special needs and interests. There were plenty of extra linens and towels. The kitchen had adequate perishable and non-perishable food supplies. Sharps were stored in a small drawer, locked and inaccessible. There was a small, locked medication refrigerator on the kitchen counter. Other medications were stored and locked in the office. The facility has two bathrooms, one outfitted for residents, with a large shower area (complete with grab bars and non-skid mat) and the other for staff. There were two fire extinguishers, serviced and fully charged on January 6, 2023. There were two operational smoke/CO2 alarms.

There were no deficiencies found at the time of inspection. No citations issued.