Facility Evaluation Report

Licensing Program Analyst (LPA) Arielle Pascua arrived at this facility on 08/04/2022 to conduct an unannounced annual visit. LPA Pascua met with Facility Designated Maria Angelica Souxouay and stated the purpose for today's visit. This facility holds a hospice waiver for 6 and has a dementia program on file.

Administrator holds a current certificate and expires on, 04/29/2023.

The facility has a main entrance COVID screening point.

Fire extinguisher located by the garage door appeared to have been annually inspected on 04/16/2022.

The kitchen area was toured. LPA Pascua observed a sufficient seven days of non-perishable as well as two days worth of perishable food supplies in the main kitchen. Additional perishable supplies were identified in an additional refrigerator located in the garage. Knives and additional cleaning supplies were locked and made inaccessible to the residents at this time.

LPA Pascua observed a locked centralized stored medication cabinet located in the dining room. Along with Administrator, the LPA observed, reviewed, and compared resident medication with the medication dispensing logs. First Aid Kit was present and contained all of the required components.

Common areas were toured. Living room, dining area and all other areas intended for resident use were observed to be furnished and maintained in compliance at this time.

A tour of the garage was conducted. Additional storage for supplies were stored in cabinets. A washer and dryer were also identified in the garage. Laundry detergent, bleach, and all other cleaning supplies were observed to be locked and made inaccessible to the residents at this time.

A tour of the bathrooms was conducted. Hot water temperature was measured and observed to be within the required range of 105-120 degrees. Grab bars were present and in good repair.