Routine inspection·May 29, 2024

On 05/29/2024 around 07:45 AM, Licensing Program Analyst (LPA) L. Holmes arrived unannounced to conduct a required Annual Inspection. LPA was greeted by Aesha Ahmed, Caregiver (S1) and upon entry and explained the purpose of the visit. The Co-Administrator's Standard Certificate (#6011402740) expires 06/20/25. The facility’s fire clearance was approved for six (6) non-ambulatory residents; hospice waivers for two (2). Shalini Bhutani, Administrator (ADM), arrived about 09:45 AM to sign the report. LPA observed four (4) clients having breakfast and two (2) in their bedrooms, LPA and S1 reviewed the Emergency Disaster Plan, and resident and staff files. LPA observed a visitor sign-in log at the entry. LPA and S1 toured the facility, including but not limited to bedrooms, bathrooms, kitchen, laundry area, common area, front and side yard. The facility consists of five (5) total bedrooms. All indoor passageways were free of obstruction. There weren't any bodies of water. The temperature for the residents was maintained at 79 degrees Fahrenheit (F) and the shared bathroom's water temperature was 107.8 F for the comfort and safety of all the residents. The bathrooms were safe, sanitary and in operating condition. Hand washing posters, paper towels, and soap observed at hand washing stations. Linen and hygiene supplies were available for all residents. PPE and paper goods remain sufficient. There was a minimum supply of 2-day perishables and 7-days of non-perishable foods. continued on LIC809C... ...continued from LIC809 Smoke detectors/carbon monoxide were in operating condition during visit. Fire extinguishers last serviced on 01/22/24, first aid kit observed complete and fire drill was last conducted on 04/012/24. Four (4) staff files reviewed all had criminal record clearance. Four (4) resident files reviewed were complete. The following forms are to be updated: -LIC500 Personnel Report -LIC308 Designation of Administrative Responsibility -LIC610 Emergency Disaster Plan to be updated Exit interview conducted and a copy of this report provided to ADM.