Facility Evaluation Report

01/17/2024 10:30 AM Licensing Program Analyst (LPA) Sarah Benson arrived at the facility unannounced to conduct a Required-1 Year inspection. LPA met with Administrator Jennifer Powell (cert # 6020036735 exp.10-21-24) and explained the purpose of the visit. Administrator certificate is current. The facility has no residents at this time.

LPA Benson and the administrator toured the facility together to ensure the health and safety of residents. Areas toured include but are not limited to two (2) resident rooms, three (3) staff rooms, common areas, two (2) bathrooms, kitchen, storage areas and back yard. In the areas toured no immediate health, safety, or personal rights violations were observed. Staff files were reviewed.

Common area was clean and in good repair. All bedrooms had required furniture, bedding, and lighting. Bathrooms were clean and in good repair. Kitchen was clean and in good repair. Facility has a locked closet for client medication.

First aid kit fully stocked and ready for emergency use. Fire extinguisher fully charged. Smoke detectors are all operational. Hot water temperature measured within required Title 22 regulations of 105 degrees F and 120 degrees F. All employees requiring background checks are cleared. All required postings are displayed within facility.

No pools/bodies of water are on premises. No firearms are on premises.

No deficiencies are being cited as a result of today’s inspection.

Exit interview conducted and copy of report was provided to Administrator Jennifer Powell.