Facility Evaluation Report

Licensing Program Analyst (LPA) Brian Balisi arrived at the facility unannounced to conduct a required annual visit at 9:40am. Upon arrival LPA met with staff and explained the reason for the visit. Administrator Isaac Adeleke arrived shortly after. At approx. 09:50am, 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 four (4) 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 in a locked closet in the hallway. Cleaning supplies, toiletries, first aid kits and PPE were observed stored here as well. LPA observed it to be inaccessible to clients in care. Laundry area was located next to kitchen.

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 #2 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.

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 sliding door to the backyard. LPA observed it to be inaccessible to residents in care. There is a dedicated area for the posting of required documents directly by the entry way. There is a fireplace in the living room that is non-operable at this time. It is screened and there are no tools. LPA observed appropriate signage regarding infection control posted throughout the facility. The facility maintained a comfortable temperature.