Facility Evaluation Report

Licensing Program Analyst (LPA) Hansen conducted an unannounced Annual inspection of facility and met with Ami Kumar, Licensee and Janine Sorenson, Administrator. Facility has 6 residents in care, 2 receiving hospice care and 5 residents with dementia diagnosis.

At approximately 11:10 AM LPA & Administrator toured the building and grounds which was found to be clean and in good repair. LPA observed all walkways and exits to be unobstructed. All residents have call buttons and motion sensors which sound in kitchen area. All notices that are required to be posted have been posted and are in a highly visible area. Facility has an approved dementia plan of operation. The amount of fresh and nonperishable foods is within regulation. Facility kitchen, refrigerators and freezers were clean, and food was stored properly. Toxins are stored in locked laundry room, hallway closet and under locked kitchen sink. Water temperature measured between 127.2 degrees F to 128.8 degrees F falling out of regulation between 105 and 120 degrees F in 5 out of 5 faucets accessible to residents in care. Licensee turned water heater down at time of visit. (see LIC809-D) There was an ample supply of cleaners, hygiene products and paper products available for residents. Bathrooms were equipped with necessary grab bars and non-slip floors/mats. Fire extinguisher inspected was last charged on 12/28/2023. Smoke detectors and carbon monoxide detectors were tested and found to be in working order. There was enough lighting in all common areas, resident rooms, and hallways. Medication is centrally stored and secure in med room off of kitchen which also contains a small refrigerator with lock for medication.

Facility to ensure that approved Admissions Agreements are always posted and/or accessible to public view in the facility as per Title 22 Regulations # 87507 (e)(2) Admissions Agreement “The licensee shall conspicuously post in a location accessible to public view in the facility a complete copy of the approved admission agreement , modifications and attachments, or notice of their availability from the facility.”