Facility Evaluation Report

Licensing Program Analysts (LPA) Alviso conducted a Required- 1 Year visit, on 324/25, at approximately 2:00pm, and met with James Homer, Administrator.

Facility has an approved dementia plan of operation. There is an approved hospice waiver for eighteen (18) residents. Facility has an infection control plan as required. The facility has a required emergency & disaster plan. Fire clearance is approved for one hundred fourteen (114) non-ambulatory, of which six (6) may be bedridden.

LPA toured the facility with the Administrator James Homer. Hot water was measured at 115.5 degrees Fahrenheit. All exits were free and clear of obstruction. All stairwells had the required evacuation chair, and user instructions posted. All required postings were up and visible to all residents, visitors, and staff. Facility has required emergency "72 hour shelter in place" supplies. Medications were centrally stored and locked in the assisted living area and in the memory care area. LPA observed that each medication room has a refrigerator for storing refrigerated medications. Food supply was observed to be sufficient.

LPA is requesting the following documents be updated and submitted by 4/24/25:

LIC308 - Designation of Administrator Responsibility

LIC610E-Emergency Disaster Plan (ensure to review and update as needed/required)

Infection Control Plan (ensure to review and update as needed/required)

Copy of LIC400 Handling of Client Cash Resources (include copy of surety bond if handling cash)