Facility Evaluation Report

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a required Annual inspection and was greeted by Administrator Phoebe Mungai. Facility contact information was reviewed.

At approximately 9:30am LPA and Admin toured the building and grounds. The facility was found to be clean and at a comfortable temperature. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Food items in refrigerator found open and not covered such as can of tuna and open onion. One zucchini found with white and blue spotting and 3 others with wilted withered skins, soft and mushy to the touch. One avocado with white spotting with concave skin . Kitchen cabinet containing cleaning supplies was locked. Kitchen drawer with sharp knives locked.

All bedrooms were equipped with lighting, night stand, and chest of drawers. All bedrooms were clean and in good repair. Extra hygiene products and linens were available. Resident bathroom had required bath mat and grab bar. Bath mat in resident bathroom showed minimal spotting of a black and brown substance, LPA advised that all bath mats must be clean and free from substances that could be toxic to residents. Water temperature in sink accessible to residents in care measured at 112.7, 111.4, and 110.9 degrees F respectively which is within the allowable range of 105 to 120 degrees F.

Facility has three [3] fire extinguishers, both of which were last inspected 3/22/2024. Smoke/Carbon Monoxide detectors located throughout the facility were operational. Facility’s last quarterly disaster drills were conducted on 6/19/2024. Facility has a backup generator for use during a power outage.

At approximately 10:30am LPA conducted review of 5 staff records. All required documentation present. LPA discussed with Admin their materials used for training. Admin advised the materials are CDs from Community Care Options from 2011.