Facility Evaluation Report

An Annual Inspection Control visit was conducted on the date & times indicated above by LPA K. Mcclurg. LPA met with Licensee/Administrator (L/A) Christine Sandoval. LPA reviewed the purpose of the visit with L/A.

Facility toured. Kitchen appeared to be clean & organized. Knives locked in drawer. 7 days Non-Perishable & 2 days Perishable food on the premises. Dining/living room sufficiently furnished & furnishings appeared to be in good repair. Resident rooms toured. Rooms sufficiently furnished & furnishings appeared to be in good repair.

Resident bathrooms appeared & smelled to be clean with no unpleasant odors. Fixtures operational. Hot water measured at 114 degrees F. All interior & exterior passageways clear with no obstructions, including exit doors of each resident bedroom. Smoke & carbon dioxide detectors tested operational. Outside area toured. Sufficient seating in good repair observed.

Exit interview conducted with L/A. Report provided @ time of visit.