Facility Evaluation Report

Licensing Program Analyst (LPA) Jill Nakagawa arrived and met with Licensees David and Sally Price. The purpose of this visit is to conduct a Pre-Licensing inspection. The fire clearance has been approved for 4 adults.

The facility is a one story home with 3 bedrooms for residents, livingroom, family room, 2 bathrooms and kitchen. The grounds of the facility were fenced and there was a shaded area available for residents use. There were no accessible bodies of water or firearms. The fire extinguisher was last inspected on 07/12/2023 and fully charged. There were 4 Smoke and 1 carbon monoxide detector which were tested and appeared to be operational. An emergency disaster plan was submitted, and the applicant has identified at least two evacuation locations.

LPA observed locked cabinets for sharps and medications. Kitchen was clean and well-equipped with an adequate supply of dishes and utensils. Refrigerator was clean, with perishable and non-perishable foods. Two additional refrigerators were housed in outdoor shed. Bathrooms had slip mats and grab-bars for resident safety. Hand washing supplies and paper products were available in sinks used by residents. Water temperature was between 105-120 degrees F, which is within regulation. A tour of residents' bedrooms was conducted and bedrooms inspected have lighting & appropriate furnishings and linens.

LPA observed the following postings: personal rights, emergency disaster drills, staff roster, activity poster and menu and the Let Us Know Complaint poster.

LPA conducted a COMP 3 with applicants; some of the following items were discussed: Administrator Qualifications, Reporting Requirements, Maintenance