Facility Evaluation Report

Licensing Program Analysts (LPAs), Martha Arroyo and Erica Mosley conducted a pre-licensing visit to this property at 9:30 a.m. LPAs met with Applicant Representative Sara Jackson as this is a change of ownership application from Sally’s Residential Care Home, Inc. #565800706 to Sally Residential Care Home 3 #565850406. The applicant has obtained fire clearance for a total capacity of six (6) residents, all of which may be bedridden in bedrooms #1 - #4. The facility has a dementia program in place.

LPAs inspected facility for Fire Safety, Personal Accommodations and Services, and Food Service. The hard-wired smoke alarms and carbon monoxide detectors were tested and function properly. LPAs observed one (1) fire extinguisher to be new and fully charged on 08/04/2024.

There is one (1) double occupancy bedroom and four (4) single occupancy bedrooms for resident use and one (1) staff room. Each bedroom is equipped with clean mattresses, pillows, and bedding. Bedrooms have sufficient lighting. There is a cabinet in the hallway with a sufficient supply of linens, including blankets, bath towels and wash cloths. There is a locked closet with the resident’s personal hygiene items. The facility has two (2) bathrooms for resident use. Resident bathrooms contained appropriate non-skid mats and grab bars. Bathrooms have sufficient paper products. Hot water temperature was measured in both bathrooms, and they measured between 105- and 120-degrees Fahrenheit. LPAs observed trash cans with tight fitting lids at the time of the visit.

LPAs toured the kitchen area at 9:40 a.m. The facility has at least seven (7) day supply of non-perishable food and two (2) days perishable food.