Facility Evaluation Report

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a required annual visit at 09:24AM. LPA initially met with facility staff. Licensee/Administrator was contacted via telephone and arrived at the facility at 09:45AM. Entrance interview conducted.

Beginning at 10:14AM, 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 following was observed:

Smoke detector was tested at 10:04AM and carbon monoxide detector was tested at 10:05AM and both were functional at the time of the visit. Fire extinguisher was observed to be fully charged and last serviced on 03/16/2023.

OUTDOOR SPACE: The backyard has a covered outdoor area equipped with furniture for resident use. All exits and passageways were observed to be free of hazards.

KITCHEN : Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Knives and cleaning supplies were observed to be locked and properly stored at the time of the visit. Emergency food and water was observed.

Adjacent to the kitchen is a separate laundry room and locked garage. Garage was observed and contained extra food, cleaning supplies and storage.

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.