Facility Evaluation Report

05/29/2024 12:00 PM Licensing Program Analyst (LPA) Rebecca Knight arrived at the facility unannounced to conduct a Required-1 Year inspection. LPA met with Velvet Peterson Program Director and explained the purpose of the visit.

LPA Knight and the program director toured the facility together to ensure the health and safety of residents in care. Areas toured include but are not limited to four (4) resident rooms, common areas, two (2) bathrooms, kitchen, storage areas and back yard. Staff and resident files were reviewed. Medications were also reviewed.

Common area was clean and in good repair. All bedrooms had required furniture, bedding, and lighting. Bathrooms were clean. Kitchen was clean and in good repair. Facility has required (7) seven-day non-perishable and (2) day perishable supply of food. Medication is locked in a locked cabinet.

Fire extinguishers fully charged and were inspected in March 2024. Smoke detectors are all operational. All employees requiring background checks are cleared. All required postings are displayed within facility.

No pools/bodies of water are on premises. The facility has been conducting fire drills and emergency disaster drills monthly.

A deficiency is being cited as a result of today’s inspection and is documented on the attached LIC809-D. LPA observed 3 inch hole in bathroom wall that needs to be repaired. LPA observed Client room 1 needs door to be replaced due to damage. LPA observed Client room 2 door is missing and the door needs to be replaced.

Exit interview conducted and copy of report was provided to Velvet Peterson.