Facility Evaluation Report

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced at 11:52AM to conduct an annual inspection. LPA initially met with facility staff. Licensee, new Administrator, and Facility Designee were contacted via telephone. All 3 (three) managers arrived shortly after the visit began. Entrance interview conducted.

Beginning at 12:02PM, the LPA, along with facility management 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:

Fire extinguishers were observed to be fully charged and recently serviced 10/04/2024. Hardwired combination smoke and carbon monoxide detectors and fire door were tested at 03:02PM. All were functional at the time of the visit.

COMMON AREA: The common areas were appropriately furnished, and the lighting was adequate. There is a television and other entertainment equipment in the living room area. Fireplace was observed to be inaccessible to residents. All furnishings were observed in good condition. All required postings were observed in common areas.

KITCHEN : Kitchen knives are stored locked and inaccessible in a drawer on the left hand side of the stove. Cleaning supplies are locked in an under-sink cabinet. The supply of perishable and nonperishable food is adequate. Appliances in the kitchen were clean and appeared functional. There is an adequate supply of emergency food and water.

LAUNDRY/GARAGE : The laundry area is located in the hallway to the right of the facility next to bedroom #1. Laundry detergent and chemicals are locked and stored inaccessible in the laundry room. The garage was observed locked and inaccessible to residents in care. The garage contained storage and a refrigerator/freezer containing extra food. Report Continued on LIC 809-C