Routine inspection·April 29, 2024

Licensing Program Analyst (LPA) Katie Brown arrived unannounced to conduct the Annual Inspection. LPA met with and explained the reason for the visit with Administrator (AD) Jean Asignacion. During this visit, AD’s pending Administrator recertification was verified to be in process. Administrator Certification #6005541740. Current census: 6 (3 residents on Hospice) During this visit, LPA toured the facility inside & out Resident rooms are found to be in good repair and contained required furnishings and lighting. The resident bathroom was clean and in good repair with faucets delivering hot water within required limits, grab bars and non-skid mats. LPA observed required hygiene items, towels, extra bedding, and linens were stored and available for use. The kitchen was clean, with necessary items and appliances. LPA observed required food supply and paper product storage. Cleaning/disinfecting supplies, knives and sharps are locked and stored separate from food. Medications are locked and centrally stored in a kitchen cabinet. The First aid kit contained required items and hot water temperature read 109 degrees. There are visitation areas available inside and out including a designated smoking area with proper signage posted. Doors and passageways are unobstructed throughout the facility. The Fire extinguishers were purchased 4/1/24. LPA conducted resident and staff file reviews. Emergency Disaster Plan and Infection Control Plans were reviewed during this visit. There were no citations during this inspection. An exit interview was conducted, and a copy of this report was provided to AD, whose signature confirms receipt. LPA requested the following updated forms faxed to CCLD by 5/20/2024: Designation of Facility Responsibility (Lic308), Administrative Organization (Lic309), Emergency Disaster Plan (LIC610E (2019), Client Roster (LIC 9020), Proof of current Liability Coverage. *Updated Infection Control Plan to be submitted upon completion