Facility Evaluation Report

Licensing Program Analyst (LPA) Brian Balisi arrived at the facility unannounced to conduct a required annual visit at 9:30am. Upon arrival LPA met with staff and explained the reason for the visit. Licensee Norma Zanders arrived shortly after.

At approx. 09:45am, LPA 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. Facility is a single-story residence and consists of a total of five (5) bedrooms and two (2) bathrooms. During physical plant tour LPA observed the required postings throughout the facility.

The kitchen appeared to be clean and the appliances and fixtures functional during the time of visit. LPA observed a sufficient amount of perishable and non-perishable food at the facility; properly stored. Sharp objects are stored underneath the sink no cleaning supplies or products were observed stored in this area. There was a staff room next to the kitchen. LPA observed it inaccessible to residents in care and empty at the time of the visit.

The resident bedrooms were properly furnished with a bed, night stand, and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets. Hallway closest near Room #4 was observed to be to store a sufficient supply of linen. LPA observed bathrooms to be clean, properly supplied and had functional fixtures. LPA observed non-skid mats. The hot water was measured in each bathroom between 105 - 120 degrees Fahrenheit. Laundry area located next to bedroom #3. LPA observed cleaning supplies and detergent inaccessible to residents in care.

The common areas were checked for cleanliness and furniture was checked for functionality during time of visit. Medications are stored in a locked cabinet next to the television. LPA observed it to be inaccessible to residents in care.