Facility Evaluation Report

Licensing Program Analysts (LPAs) Alviso and Mutialu conducted a Required- 1 Year visit, on 4/16/24 at approximately 8:40am, and met with Licensee/Administrator Bana Solomon. There currently are four (4) residents in care.

Facility has an approved dementia plan of operation. There is an approved hospice waiver for six (6) residents. Facility has a required infection control plan. Facility has an emergency and disaster plan as required. The facility does have emergency food, water, and supplies to meet the "72 hour shelter in place" requirements. Facility has a fire clearance approval for a total of six non-ambulatory, of which one (1) may be bedridden.

The LPAs reviewed four (4) resident files. All files were complete.

The LPAs reviewed five (5) staff files. All staff have criminal record clearance. All staff have current first aid and CPR certification as required.

The LPAs toured the facility with the Administrator Bana. The hot water was checked at 114. to 116.6. degrees Fahrenheit , which is within regulation. The fire extinguishers were tagged and serviced as required- expires 2/2/25. All exits were unobstructed. Food supply was sufficient. All bathrooms have grab bars, and non slip flooring for resident use. The facility is well lighted, including all resident rooms and bathrooms. The facility was observed to be at a comfortable temperature. All medications were locked up and not accessible to residents in care. Facility had sufficient furnishings for client use.