Routine inspection·January 29, 2024

On 01/29/2024, Licensing Program Analyst (LPA) Jaynae Boyles, arrived at the facility unannounced to conduct a 1-Year Required Annual Inspection. LPA met with Facility Administrator, Chablis Pasquale and explained the purpose of the visit. LPA Boyles and Administrator toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedrooms, and common restrooms. LPA observed the facility to be clean, in good repair and odor-free. Each bathroom to have the necessary grab bars, non-skid flooring or shower chair, paper towels, trash can with lids and 20-second hand-washing poster. LPA observed all the resident bedrooms to have the required furnishings, working lights and operational windows with screens. LPA checked the kitchen area for the ability to prepare and store food. Care home has required (2) two-day perishable and (7) seven-day non-perishable food supply on hand. LPA observed knives, cleaning products and other toxins to be locked away and inaccessible to residents. LPA observed the outdoor area and perimeter of the care home to be free of clutter and debris and there appeared to be no potential safety hazards to the residents in care. Smoke detectors and carbon monoxide detector are operational. Fire extinguisher and first aid kit are maintained and ready for emergency use. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA reviewed a total of six (6) residents' files and three (3) staff files. LPA observed the staff files to have all the required documentation. LPA observed two residents to have dementia and not have an annual medical assessment in the file. LPA observed three residents to have bed rails in their room with no medical order in the file and LPA observed two residents to have bed rails in their room and medical orders in the file. Administrator reported that there are orders for the bed rails but that these files could not be located. Administrator stated that annual medical assessments were conducted but that the paperwork was not placed in the file. Administrator did provide LPA some paperwork regarding medical appointments completed for residents. Several topics were discussed. No deficiencies are being cited as a result of today’s inspection. Exit interview conducted and copy of report left at the facility.