Routine inspection·November 13, 2024

On 11/13/2024, Licensing Program Analyst (LPA) Rachel Bruce arrived unannounced at the facility for the purpose of conducting an annual inspection. LPA was met by Raul Tiburcio, Administrator (AD) and was provided a tour of both the interior and exterior of the home. LPA explained the purpose of the visit and AD had no questions. The home has 6 bedrooms, 2.5 bathrooms, an office lounge area, a garage being utilized for storage and currently a vacant bedroom is being used for office and storage. Currently there are 4 residents, 3 non- ambulatory and 1 ambulatory. LPA observed the bedrooms to be clean and orderly and all had appropriate furnishings meeting regulatory requirements. All bedrooms are private. In the resident bathrooms LPA observed required items, non slip mat and grab bars. LPA was unable to test hot water temperature as thermometer was broken. Temperature felt appropriate to the touch but cannot be confirmed at the time of the inspection. Resident hygiene supplies were properly stored and available. The kitchen was toured and observed to be in good repair with necessary items and appliances. Dishware and utensils sufficient for 6 residents observed Sharps and knives were properly stored and were locked and inaccessible. LPA observed food supply and found that there was sufficient perishable items meeting the 2 day requirement however, there was not 7 days of non-perishable food available. This will be addressed separately in a case management report dated 11/13/2024.. Medication records were reviewed and found to be accurate and updated. Pill count was conducted and no errors found. Medications are centrally stored and locked in a cabinet located in the kitchen. Facility has designated visitation areas available inside and out. Doors and passageways are unobstructed throughout the facility including outdoors. The self latching gate at the side of the house has to be manually closed as the wood has swollen. AD to remedy that by trimming gate or rehanging. First aid kit located in kitchen cabinet and found to contain required items. Fire Extinguisher also located in the kitchen was serviced in February 2024. Smoke and carbon monoxide detectors (combo alarm) tested and found to be operational; they are hardwired to the other smoke detectors in the bedrooms and common areas. LPA observed all sounded when one was tested. LPA conducted resident and staff file reviews. LPA chatted briefly with residents that were able to communicate and no resident brought up any issues or concerns. Administrator’s re-certification was confirmed to be in pending status.