Facility Evaluation Report

Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced at 10:20AM with the purpose of conducting a required annual visit. The LPA initially met with facility staff. Administrator Dvora "Debbie" Leventer was contacted via telephone and arrived shortly thereafter. Entrance interview conducted.

Beginning at 10:37AM, 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:

Fire extinguisher was observed to be fully charged and last serviced 06/03/2024. Hardwired combination smoke/carbon monoxide detectors were tested at 12:38PM and were functional at the time of the visit.

BEDROOMS : There are (7) seven bedrooms in the facility; the facility has (6) six private bedrooms for resident use, and (1) one room that is used as a staff room. The staff room is kept locked. All resident rooms were observed and contain appropriate furnishings, linens, and adequate lighting.

BATHROOMS : There are (7) seven full bathrooms. There are (6) six private bathrooms for resident use, the full bathroom at the entrance of the home next to Room A (Staff Room) is designated for staff and guests. The showers are equipped with nonskid surfaces and available nonskid mats. Grab bars were observed in the bathrooms. Hot water temperature in bathrooms measured within the required range.

LAUNDRY : The laundry area is in a locked laundry room located in the main hallway. Laundry detergent and cleaning supplies are stored inaccessible in the locked laundry room.

GARAGE: The garage was observed to be locked and contain storage, a refrigerator and freezer, both containing extra food.

COMMON AREA: The common areas were appropriately furnished and the lighting was adequate. There is Report Continued on LIC 809-C