Facility Evaluation Report

Licensing Program Analyst (LPA) Valeria Conway arrived at the facility unannounced to conduct a required annual visit at 10:20 A.M. LPA initially met with facility staff. Licensee/Administrator was contacted via telephone and arrived at the facility at 10:45 A.M. Entrance interview conducted.

Beginning at 10:52 A.M., the LPA, along with Licensee/Administrator toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The facility serves residents with dementia, the auditory alarms on the exit doors were tested and functioned properly at the time of visit.

COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, living room and dining room furniture was observed to be in good condition. The LPA observed the required postings in the common area. A fireplace was observed to be inaccessible to residents in care. The facility maintained a comfortable temperature of 70 degrees. Facility provides sufficient space to accommodate both indoor and outdoor activities. LPA observed a working phone available for residents use whenever needed. All hard-wired combination smoke alarm and carbon monoxide detectors were tested at 11:39 A.M. and function properly at this time. Fire extinguishers were observed to be fully charged and purchased during today’s visit. The two (2) common living and dining areas are clean and properly furnished. During the inspection, the LPA observed in the common area located next to room #4, room #5 and the staff room a television that was turned on. Additionally, the LPA noted Resident #1 (R1), sleeping on the facility couch, despite the resident having their own room. It was also observed that the resident’s room does not have a television. When questioned, Administrator stated that resident prefers not to have a television in their room. LPA observed cameras in the common areas only.