Facility Evaluation Report

At approximately 8:50 AM, Licensing Program Analyst (LPA) Robert Frank arrived to conduct an unannounced Pre-Licensing visit and met with Caring Hands House Manager/Pending Administrator Karen Sims. Applicant Rose Woodward was out of town during the inspection. LPA spoke with applicant via telephone. Applicant stated that Karen Sims would become facility Administrator post-licensing. Applicant has applied for a Change of Ownership for an existing Residential Facility for the Elderly (RCFE) identified as Villas at Cloverdale (496803142). Facility currently provides care to older adults and has a dementia care program on file. Facility received an approved fire clearance dated 10/30/2024 that allows for a total capacity of six (6) non-ambulatory residents. Upon arrival, LPA was informed that there are currently four (4) residents in care.

LPA conducted a physical plant walk-through. LPA observed the following: Per facility sketch, facility is a one (1) story residence with four (4) resident bedrooms, two (2) bathrooms, and common areas. Facility has one (1) small separate building on-site used for storage. The garage has been turned into a staff break area. Facility was found to be clean with all exits free from obstruction. Facility had emergency lighting. Facility's door alarms were tested and operational. LPA observed required postings including the CCL Complaint Poster and Personal Rights. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Facility's hot water temperatures for all sinks were within Title 22 Regulations of 105F to 120F. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for residents. Toxins were observed to be stored inaccessible to residents. Bathrooms were equipped with necessary grab bars and non-slip floors/mats were present. All resident rooms were furnished with a bed, lamp, dresser, and chair.