Facility Evaluation Report

Licensing Program Analyst (LPA) Jill Nakagawa arrived unannounced on 02/27/2026 to conduct an Annual Inspection of the Care Home at Peacock and found the facility to be clean and a comfortable temperature. There were six residents and two care staff at the facility at the time of visit. Residents appeared clean and well-cared for. Administrator arrived shortly after LPA's arrival.

Facility has a fire clearance approval for a total of six (6) non-ambulatory, of which one (1) may be bedridden.There is a hospice waiver for six (6). .

All exits were unobstructed in the home. All exit doors had auditory alarms and the alarms were working properly during the inspection. Fire extinguisher is serviced and tagged as required- 03/24/2025. There are seven (7) smoke alarms and two (2) carbon monoxide detectors which were functioning at the time of inspection. The water temperature measured between 115.1 - 115.3 degrees Fahrenheit which is within regulation.

The kitchen was clean, sanitary and well organized with a sufficient supply of food, perishable and non-perishable as required per regulation. Sharps are secured and inaccessible by residents. Medications and resident records are stored in a secured hall closet used for storage: locked at all times, with a key-code entry pad.

LPA observed sufficient supply of cleaners, paper products, hygiene products, and personal protective equipment (PPE), all stored in locked garage.

A review of 3 resident and 3 staff records found them to be complete.

LPA requested that the Emergency/Disaster Plan and Infection Control Plan be updated and submitted to CCL by 3/15/2026, as well as an updated LIC500 and proof of liability insurance.

No citations were issued at the time of visit.