Facility Evaluation Report

At approximately 12:45PM, Licensing Program Analyst (LPA) Contreras arrived unannounced to conduct a required annual inspection. LPA was greeted by facility Administrator(admin) James Sirokman. Facility is a 7 bed, 3 bath Residential Care Facility for the Elderly that has a fire clearance approved for 11 bedridden residents with a hospice waiver approved for 6 residents.

LPA and admin toured the building and grounds which was found to be clean and in good repair. Facility was at a comfortable temperature. LPA observed all walkways and exits to be unobstructed. All required postings were in a highly visible area. Fire extinguishers were charged and last inspected 6/03/2024. Facility has commercial fire system through the fire department. Auditory signal systems throughout facility were functional. Outdoor emergency exits clear from obstruction. LPA had conversation with admin about recording all disaster drill conducted.

All bedrooms were equipped with lighting, a night stand and chest of drawers. All bedrooms were clean and in good repair. Resident bathroom had required bath mat and grab bar. Water temperature measured at 108.3 degrees F at faucets accessible to residents which is within the allowable range of 105 to 120 degrees. Facility has well water system last inspected on 6/23/2025.

LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food.

Facility kitchen refrigerators and freezers were clean, and food was stored properly with expiration dates noted. LPA observed food thickener to not be centrally stored, caregiver removed food thickener and placed with centrally stored medication. LPA had conversation with admin to keep all food thickener locked and secure at all times. Extra supply of frozen, perishable, non-perishable food and water located in outdoor workshop. Toxins are stored in a locked cabinet and inaccessible to residents. Sharps and knives were locked in kitchen drawer. Extra linens and towels were stored in closet. Storage shed in backyard stored extra hygiene products for residents.