Routine inspection·July 5, 2023

On 7/5/2023 starting at 1:20 PM, Licensing Program Analyst (LPA) L. Fici arrived unannounced to conduct 1-Year Annual Required Inspection. LPA met with Emily Poon, Administrator (ADM) and explained the purpose of the visit. Administrators certificate (6003257740) is valid and expires on 3/25/2024. The facility’s fire clearance was approved for eighty-five (85) non- ambulatory residents, which forty-three (43) may be bedridden and 4 residents may be on hospice. Upon entry, LPA observed five (5) staff and seven (7) residents present during inspection. Starting at 1:50 PM, LPA toured facility with ADM including but not limited to sixty-four (64) bedrooms and 69 bathrooms, kitchen, common area and backyard. The facility consists of 64 total private bedrooms which 10 bedrooms are shared. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 71 Degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents'. The hot water temperature in residents’ bathroom was measured at 117.7 Degrees Fahrenheit. Residents’ bathrooms are equipped non-skid mats. There is a minimum of one-week supply of nonperishable and 2-day supply of perishable foods. Sharps and toxins were locked and inaccessible to residents'. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was observed last serviced on 7/20/2022. First aid kit was observed to be complete. Continue on Lic809-C Continued from Lic809 Starting At 2:23 PM, LPA reviewed 10 of 10 staff records. At 3:16 PM, LPA reviewed 10 of 10 residents' record. At 4:26 PM, LPA reviewed a sample of 10 of 10 residents' medications. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 7/12/2023: · LIC 308 Designation of Administrative Responsibility · LIC 500 Personnel Report · LIC 610D Emergency Disaster Plan (9 Pages) · Liability Insurance No deficiencies cited during visit. Exit interview conducted with ADM, and a copy of this report provided.