Facility Evaluation Report

Licensing Program Analyst Jason Lund arrived unannounced to conduct an annual/required visit. Administrator, Kashmindar Kaur, came a short time later. This facility is licensed to serve and accept up to 6 residents who are deemed to be ambulatory and non- ambulatory. Census: 4

LPA Lund and Administrator Kashmindar Kaur tour/inspected was conducted. Kitchen area was toured. Cabinets and drawers were reviewed. Drawers and cabinets housing cleaning supplies were observed to be locked and made inaccessible to the residents at this time.Drawers containing knives and other cutlery were observed to be locked and made inaccessible to the residents at this time.

Food supply was reviewed for 2-day perishable and 7-day nonperishable food quantities at this time. Additional nonperishable food items were observed to be stored in the garage area along with an additional refrigerator unit. Dining room, living area, and all other areas designated for resident use were observed to be maintained and observed to be in compliance at this time. Resident’s bedrooms were inspected. Furniture and furnishings were observed to be present and maintained in compliance at this time. Resident’s restrooms were inspected. Shower areas, toilets, and wash basins were reviewed and observed to be functional and in good repair at this time. Hot water temperatures were taken and measured to make sure that they were within the allowed range of 105-120 degrees.