Facility Evaluation Report

Licensing Program Analyst (LPA) Zabel Chochian arrived at the facility to conduct a required annual inspection. LPA was greeted by staff and informed them of the reason for the visit. Administrator Laila Kulungu was called and reason for the visit was explained.

The LPA and the staff 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: KITCHEN : Kitchen knives are stored locked and inaccessible in a drawer in the kitchen. The facility has a sufficient supply of perishable and non-perishable food. Appliances in the kitchen were clean and functional. There is an adequate supply of emergency food and water. Medications are stored in a locked kitchen cabinet and files are stored in a locked filing cabinet in the office area next to the kitchen. GARAGE/ LAUNDRY : The attached garage by the kitchen is kept locked. LPA observed the pantry, an additional refrigerator/freezer, and a washer and dryer. Laundry detergent and chemicals are stored inaccessible in the garage. BEDROOMS : There are six (6) bedrooms in the facility; all bedrooms for resident use are private. There is no staff room in the facility as there is no live in staff. Three (3) of six (6) rooms have direct access to the outside. Lighting in the rooms is adequate. All resident rooms were set up with beds, night stands, lighting, chests of drawers, chairs and closet space. Full rail observed on resident #1's (R1) bed. R1 is not on hospice. BATHROOMS : There are three (3) full bathrooms. There are two (2) private bathrooms for resident use and one (1) hallway bathroom for resident use. The showers are equipped with nonskid surfaces and nonskid mats. Grab bars were observed in the bathrooms. Hot water temperature in bathrooms measured between 106.9 – 111.7 degrees Fahrenheit, which is within the required range. COMMON AREAS: Common areas were appropriately furnished and in good condition. The facility smoke alarm system is hard wired; smoke detectors were tested and were operable at the time of the visit. (Continue to LIC809c)