Routine inspection·August 23, 2024

Licensing Program Analyst (LPA) Mariana Agban conducted an Annual Required visit and inspection of the facility. LPA met with Administrator, Chita Beltran and explained the reason for the visit. At approximately 9:40 am, with the assistance of Administrator, LPA took a tour of the physical plant. Required postings were observed in the entry area. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives were stored in a locked drawer in the kitchen. Properly labeled medications were locked in one of the kitchen cabinets. Bedrooms: There were three (3) bedrooms designated for residents' use and one (1) bedroom is designated for staff' use. All three bedrooms, in use by residents, were properly furnished with appropriate beddings and linens with sufficient lighting. Bathrooms: There are two (2) bathrooms designated for residents' use. Both bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured from the bathroom sink at 111.2 degrees Fahrenheit. No cleaning supplies or hazardous items were present in each bathroom during the inspection. Common Areas : These included the living room and dining area. The common areas were properly furnished. Surrounding Grounds : Entry/exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. There is a shed in the backyard being used as a used equipment storage. The shed was observed to be locked. There is no body of water in the facility. The laundry area is located by the kitchen, all laundry detergents were locked. Resident Files : LPA conducted a file review of resident records to insure compliance of licensing forms. LPA observed that R2 and R6 are missing updated Medical assessment. Administrator was advised to update both resident's medical assessment promptly. Staff Files : LPA also conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms. Medications : Medication and Medication Records were review for proper documentation. Temperature: Facility maintains a comfortable temperature of 77 degrees Fahrenheit. (Continue on 809C) All smoke alarms and carbon monoxide detectors were observed to be functioning properly. The fire extinguisher is located in the kitchen with purchase date 08/23/24. Exit interview conducted, citation issued, appeal rights given and copy of this report delivered.