Routine inspection·June 21, 2024

On 06/21/24 Licensing Program Analyst (LPA) M. Garza arrived unannounced for an annual inspection visit. LPA was met by House Manager, Virginia Jimenez. LPA introduced self, explained reason for visit and was permitted entry into the facility. LPA toured the facility inside and out. LPA completed a health and safety check on residents in care. 2 of 5 residents present and in rooms at time of visit. Pathways and doors were clear and free from obstruction. Facility was clean and without odor. Common areas were clean, adequately furnished, and adequately lit. Smoke detectors and carbon monoxide detectors were present and operational at time of visit. Fire extinguisher last serviced 02/07/2024. Last fire drill on 4/10/24. Resident rooms observed. Linen supplies are kept in linen closets. Sharps, chemicals and medications were located in locked cabinets. LPA observed covered patio area. During visit the following issues were observed: screens missing on windows and in need of replacements, carpet in living room torn and in need of repair/replacement, tile in bathroom #1 and entry way broken and in need of repair/replacement, cabinets in bathroom #1 in need of paint/repair, 3 of 5 bedrooms missing night stands, bedroom #3 in need of new mattress, sharps observed in bedroom #4, crack where ceiling meets wall in bedroom #5 in need of repair, light cover missing in laundry room, light plate cover in hallway broken and in need of replacement. LPA requested the following documents to be submitted to CCL by 6/28/24: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-E), Affidavit regarding Resident Cash Resources (LIC 400), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) in order to update the facility file. Deficiencies and TV's cited per Title 22. Exit interview completed with House Manager, Virginia. A copy of this report, deficiencies, TV's and appeal right provided.