Facility Evaluation Report

Unannounced annual visit made out to this facility on 08/29/2022 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility designated Administrator, Kashmindar Kaur, who was briefly interviewed. It was learned that there was (1) resident under the care of hospice at this time while (3) other residents were receiving services through home health.

This facility does have a hospice waiver for (6) residents and fire cleared for (1) bedridden resident at any given time.

A tour of this facility was conducted alongside the facility designated Administrator Kashmindar Kaur.

Administrator certificate was observed to be present and in compliance at this time for facility designated Administrator Kashmindar Kaur.

Kitchen area was toured. Cabinets and drawers were reviewed.

Food supply was reviewed for adequate 2-day perishable and 7-day nonperishable quantities at this time. This LPA did observe additional food storage units which were present and functional at this time in the garage area.

A tour of the dining area, living area, and all other areas intended for resident use was conducted.

Medication cabinet, located in the kitchen area, was reviewed. Policies and procedures involving dispensing, documenting, and overall administration of resident medications was discussed with the facility designated Administrator. This medication cabinet was observed to be locked and made inaccessible to the residents at this time.

A tour of the resident bedrooms and restroom was conducted. Furniture and furnishings were observed to be sufficient and able to meet the needs of the residents at this time.

Hot water temperature was taken and measured to make sure that it was within the allowed range of 105-120 degrees.

Linen closet, located in the entry way, was observed to contain a sufficient supply of towels, blankets, and linens to meet the needs of the residents at this time.