Facility Evaluation Report

At approximately 9:15 AM, Licensing Program Analyst (LPA) Elias Magdaleno arrived unannounced to conduct a required 1-year annual inspection and was greeted by Administrator Nikiyah Jones. Facility is a Residential Care Facility for the Elderly (RCFE) with three (3) residents in care. Facility has a Dementia Care Plan, a Hospice waiver for one (1), with one (1) Hospice residents currently in care. Facility is approved for three (3) non-ambulatory and one (1) bedridden residents.

At approximately 9:40 AM, LPA initiated a tour of the facility with Administrator and observed the following: Facility is a one (1) story home, was a comfortable temperature, and passageways were free from obstructions. Fire extinguishers were last inspected 8/24 and 3/25. Smoke and Carbon Monoxide detectors are hardwired and serviced by the local Fire Marshall. Water temperatures measured 115.7 and 114.8 degrees F, which is within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens, hygiene, incontinent care, and paper products available for residents. Residents' bedrooms were inspected and observed to have all the appropriate furnishings as outlined in Title 22 regulations. Laundry room and cabinets containing cleaning supplies and other items that could pose a risk were locked.

LPA observed at least a two (2) day supply of perishable and seven (7) day supply of non-perishable food. Food was found to be stored in a safe manner with open items covered. There is a shaded seating area in the backyard with outdoor space for activities. Facility is also equipped with an activities room that is supplied with various materials for arts and crafts. Facility telephone was observed operational during inspection.