Facility Evaluation Report

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced at 10:37AM to conduct an annual inspection. LPA initially met with facility staff. Administrator & Facility Designee were contacted via telephone. Designee Connie Roush arrived at 10:47AM, Administrator arrived at 11:10AM. Entrance interview conducted.

At 10:52AM, the 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. The following was observed:

Fire extinguishers throughout the facility were observed to be fully charged, but 2 (two) indicated were last serviced 10/08/2022; the third did not indicate a date purchased or date serviced. Facility management showed LPA there are new recently purchased extinguishers present in the facility garage, which will be exchanged for the ones inside. Hardwired smoke and carbon monoxide detectors and fire doors were tested at 02:35PM and were functional at the time of the visit.

BEDROOMS : There are 8 (eight) bedrooms in the facility; the facility has 6 (six) private bedrooms for resident use, and 2 (two) staff rooms. Both staff rooms are kept locked. All resident rooms were observed to contain adequate lighting, proper furnishings and linens.

BATHROOMS : The facility contains 4 (four) bathrooms; there are (2) two full bathrooms in the hallways. There are two (2) private bathrooms for resident use. The showers are equipped with nonskid surfaces and available nonskid mats. Grab bars were observed in the bathrooms. Hot water temperature in all resident bathrooms were well under the required range, measuring between 71.6 and 72 degrees Fahrenheit. In the hallway bathroom on the left, cleaning supplies were observed unlocked under the sink. In