Routine inspection·September 23, 2024

On 09/23/24 at 11:00 am Licensing Program Analysts (LPA) J. Clancy-Czuleger arrived unannounced to do an annual inspection. LPA meet with Mary 'Rose' Malekamu/Administrator and explained the purpose of the visit. LPA inspected the facility inside out. There is no body of water. Physical plant is consistent with the facility sketch received by Central Application Bureau (CAB) and approved by the fire department. LPA inspected the living room, dining area, kitchen, bedrooms, hallways, bathrooms, side and backyards. Bedrooms were observed appropriately furnished with adequate lighting and drawers. Facility has sufficient towels, extra bed sheets and comforters. Equipment and supplies for residents' personal hygiene are available and on site. Dinner and silver wares were observed sufficient for residents' use. Food supplies checked and observed good for seven days of non-perishables. Facility was observed equipped with refrigerator, microwave, dishwasher, washer and dryer. Cabinet for knives, cleaning supplies, and central storage for medications were observed with locks. Activity supplies were available. Outdoor activity space was observed furnished with tables, chairs and shade. The facility has a mitigation plan. Fire extinguishers were observed fully charge and tags showed serviced 04/16/2024. At 12:02 pm LPA reviewed 4 residents records. At 12:45 pm, LPA reviewed 2 staff records and 2 of 2 were fingerprint cleared and associated to the facility. Continued on LIC809C... ...Continued from LIC 809 The following deficiency was observed during the visit: Chemicals in Laundry room and bathroom left unlocked Staff records are not complete R4 does not have admissions agreement in file Residents do not have Safeguard Property and Valuables form in files R1 and R2 need updated medical assessments No sign for oxygen tank The Facility was cited, and citations can be found on the LIC 809-D. Exit interview conducted. Appeal Rights and a copy of this report provided.