Facility Evaluation Report

On 04/07/23, Licensing Program Analyst (LPA) L. Salazar arrived to the facility unannounced to conduct the required Annual Inspection Visit. LPA was greeted by Administrator, stated the purpose of the visit and was allowed entry into the facility. Administrator on record is Kimberly Lyons #600424735 Expiration 10/15/24. Administrator certificate is observed posted on the wall.

LPA conducted a tour of the facility, inside and out. Facility temperature was 73 degrees F. Resident was with family at the time of visit. Facility is a 4 bedroom 2 bathroom home. Private resident bedrooms were observed to have the required lighting and furnishings and were free from odor and free from any passageway obstruction / fire hazards. LPA observed the required 7-day supply of non-perishable food and 2- day supply of fresh perishables to be properly stored. An emergency disaster supply was observed.

Bathrooms were toured and observed to have operational lights, running water, and non- slip floors. Hot water temperature tested at 113 degrees F. Trash can with lid and hand washing postings were observed. Internet device and a working phone line were observed to be available for residents in care. A supply of extra linen's and towels were observed in the hall.

Carbon monoxide and smoke detectors were observed to be operational. Carbon Monoxide detector was located in Living Room. A State Fire Marshall approved automatic fire sprinkler system was observed to be operational. Night lights were observed in the hallways. Fire Extinguisher was observed with a service date of 02/06/23. First aid kit was observed and contained all required items. (Continued on 809-C)