Facility Evaluation Report

Licensing Program Analyst (LPA) Zabel Chochian arrived at the facility unannounced to conduct a required annual visit. Upon arrival LPA met with staff. Administrator was contacted and arrived to facility shortly after LPA. Reason for visit was stated.

The LPA toured the physical plant areas inside and outside with staff at approximately 2pm.

KITCHEN: Knives and cleaning supplies are stored in a locked cabinet under the sink. Kitchen appliances appeared to be in operable condition. Perishable and non-perishable food appeared sufficient.

BEDROOMS: The LPA observed four single-occupancy client bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting.

RESTROOMS: Restrooms observed clean and sanitary and in operating condition. Hot water temperature measured at 118.6 in the restroom used by clients.

COMMON SPACES: 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 living room.

The backyard has a covered outdoor area equipped with furniture for resident use. There is a self-latching gate on the side of the facility. There is a gated pool in the backyard, which was locked. The laundry area is in the backyard and the detergents kept inaccessible.

Staff and client files reviewed from 2:30pm-3:30pm. All required forms and training observed on file for staff. Client files have current needs and serves plan; physician report, admission agreement and IPP's. Medication are kept locked in the hallway closet. At approximately 3:30pm, client medication procedures, storage and administration logs observed. Medications observed stored locked and inaccessible in the hallway closet. Medication are dispensed according to physician orders. PRN authorization letters observed on file. No deficiencies observed during todays visit. Exit interview conducted copy of report provided.