Facility Evaluation Report

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a required annual visit. Upon arrival, LPA met with facility staff. LPA explained the reason for the visit. The Administrator arrived at 02:51PM. Entrance interview conducted.

Beginning at 03:06PM, the LPA along with Administrator, 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:

COMMON AREAS: Living room and dining room furniture was observed to be in good condition. There is a screened fireplace in the living room. The facility maintained a comfortable temperature throughout the visit. Smoke detector(s) and carbon monoxide detector were tested at 03:31PM and were operational at the time of the visit. The fire extinguishers were observed to be fully charged and last serviced 05/14/2024. All exits have auditory devices. The LPA observed required postings throughout the common space.

KITCHEN: Knives and cleaning supplies are locked in an under the sink cabinet. Kitchen appliances were in operable condition. The facility has a sufficient supply of perishable and non-perishable food.

GARAGE AND GROUNDS : The garage is attached to the house and locked at all times. The laundry room is located in the main hallway and is kept locked and inaccessible. Cleaning supplies and disinfectants are kept in locked cabinets in the laundry room. There is one (1) additional refrigerator in the garage with perishable items in good condition. Facility has an adequate amount of emergency food and emergency water. There is patio furniture including a table, umbrella, and chairs for resident use. Facility has one (1) fence gate that self-latches with clear passageways for emergency exit use. There were no bodies of water noted. Garage contains a staff room, which Administrator stated is permitted.