Facility Evaluation Report

Licensing Program Analysts (LPAs) Kelly Dulek and Quoc Huynh arrived at the facility unannounced to conduct a required annual visit at 11:57AM. The LPAs were greeted by staff and informed them of the reason for the visit. Administrator Kathie Flood and co-Administrator David Flood arrived shortly thereafter.

Beginning at 01:06PM, the LPAs and Administrators 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:

BEDROOMS/RESTROOMS: Bedrooms were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are six (6) designated resident rooms, 1 (one) staff room and 1 (one) staff break room. There are 3 (three) total bathrooms in the facility; 1 (one) is designated as a shared resident restroom, 1 (one) is a private bathroom and 1 (one) is designated as a staff restroom. Restrooms were clean and sanitary and in operating condition with grab bars and non-slip surfaces. All restrooms were sufficiently stocked with soap and paper towels. Hot water was tested in the common restroom and measured within the required range.

COMMON AREAS: At the time of the visit, living room, family room, and dining room furniture was observed to be in good condition. There is a fireplace in the living room, which was observed to be screened and inaccessible. The facility maintained a comfortable temperature throughout the visit. Hardwired combination smoke and carbon monoxide detectors as well as fire doors were tested at 01:37PM and were operational at the time of the visit. The fire extinguisher was fully charged and purchased on 02/25/2025. The LPAs observed required postings on the dining room wall.

KITCHEN: The LPAs observed the facility kitchen. Knives are stored inaccessible. Cleaning supplies are stored inaccessible in the attached garage. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food. Continued on LIC 809-C