Facility Evaluation Report

Licensing Program Analysts (LPAs) Kelly Dulek and Emily Peraldi arrived at the facility unannounced to conduct a required annual visit at 09:55AM. This annual had a specific emphasis on infection control practices and procedures. The LPAs met with Licensees Teresita and Larry Wayne and discussed the reason for the visit.

The LPAs, along with facility Licensee Larry Wayne, 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:

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 LPAs observed the required postings in the common area.

Two (2) fire extinguishers were observed to be fully charged and purchased on 02/27/2022. Smoke detectors were tested at 3:03PM and were functional at the time of the visit. Carbon monoxide detector was tested at 3:04PM and was functional at the time of the visit.

The backyard has a covered outdoor area equipped with furniture for resident use. LPAs observed the exterior of the facility to contain items on the side of the house and in the backyard. The licensee stated these items are going to be moved to a new shed or donated. There were no bodies of water noted. The garage was observed locked. At 10:02AM, LPAs observed a knife in the backyard area on top of a chair. At 10:05AM, LPAs observed a second knife on the outdoor patio on top of a ledge/shelf.

The laundry room was observed to be locked and contained items the Licensee stated will be donated. Licensee stated one of the laundry machines is currently inoperable and laundry is being taken off site to wash.