Facility Evaluation Report

Licensing Program Analyst (LPA) Maja Jensen arrived at the facility unannounced to conduct a POST LICENSING visit. LPA Jensen met with Jessica Ruiz and Randy Woods and explained the purpose of today's visit.

LPA Jensen toured the facility and the grounds including but not limited to dining room, living room, all resident bedrooms, kitchen and smoking area. The facility was observed to be clean, free of odor and adequately furnished. The temperature in the facility was set at 78 degrees which falls within the required regulatory range of 68-85 degrees. The water temperature in the resident bathroom was 107.2 which falls within the required regulatory range of 105-120 degrees. The fire alarm and carbon monoxide detectors were observed to be in good repair. The fire extinguishers were last serviced on 8/20/21 and are in compliance. The facility's emergency disaster plan was reviewed and is in compliance. The grounds were observed to be well maintained and free of debris with clear exit paths.

LPA Jensen reviewed a staff file and a resident file which were both observed to be complete and well organized. The staff file was observed to have training records well documented the amount of training was observed to be in excess of regulatory requirements. The staff CPR certification was current. The P&I ledgers were reviewed and observed to be consistent and complete. The MAR for resident 1 was observed to be consistent and complete.

The facility was observed to have in excess of a 2 day supply of perishable food and a 7 day supply of non- perishable food. The refrigerator and freezers were observed to be clean and clear of debris. A supply of PPE in excess was observed to be available on site. The first aid kits were observed to be complete.

The staff on duty were verified to be fingerprint cleared and having met all training requirements.