Facility Evaluation Report

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a required annual visit at 12:18PM. LPA met with Licensee/Administrator Bernadette Abiera. Entrance interview conducted.

Beginning at 12:24PM, the LPA, along with Licensee/Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that facility is in compliance with Title 22 Regulations. Please note: the facility is a 2-story house; the upstairs area is inaccessible to residents in care and is used for staff only, therefore was not observed. The following was observed in the downstairs area:

Fire extinguishers are fully charged and recently serviced 01/15/2024. Carbon Monoxide detector was tested at 01:32PM, smoke detectors were tested at 01:31PM and all were functional at the time of the visit. No fire clearance concerns were observed.

KITCHEN : The LPA observed the kitchen to be clean. Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of seven (7) days non-perishable and two (2) days perishable food. Cleaning supplies and sharps are located in separate locked cabinets.

COMMON AREAS : This includes the living room and dining room areas. LPA observed common area to be clean and properly furnished at the time of the visit. Exit doors contain alarms and were functional at the time of the visit.

BATHROOMS : There are two (2) bathrooms for resident use. Both are designated for shared resident use. Restrooms were observed to be equipped with nonskid surfaces and contain nonskid mats. Grab bars were observed in the bathrooms. The water temperature was measured in one shared resident bathroom and measured within the required range.

BEDROOMS : There are four (4) bedrooms in downstairs portion of the facility; two (2) are designated as