Routine inspection (multi-day)·December 5, 2023

Licensing Program Analyst (LPA) Cynthia Chan conducted a subsequent visit to finish the annual inspection. LPA met with licensee/administrator, Richard Rabena, and explained the reason for the visit. During the visit today, LPA completed the remainder of the inspection and the following were reviewed: Staffing : The facility has sufficient staffing to meet the needs of the residents. All staff members have current CPR & First Aid certificates. Per the licensee, there is backup staffing if needed. Personnel Records-Training : LPA reviewed 3 Staff files. The administrator's (Richard Rabena) certificate expires on 7/27/25. Staff have fingerprint clearance and associated to the facility. Staff files have the required documents such as personnel record, health screening with TB results, employee rights form, and in-service training. Staff also have appropriate dementia care training. Resident Records-Incident Reports: LPA reviewed 6 resident files that are maintained at the facility. The files contain the admission agreement, medical assessment with TB results, consent forms, property valuable form, preappraisal form, and personal rights form. The physician's report for Resident #3 diagnosed with dementia is not current. Resident Rights-Information : Information for appropriate reporting agencies are posted at the facility. Residents' rights are respected and implemented by staff. Planned Activities : Facility has sufficient space to provide indoor and outdoor activities to accommodate residents who are physically handicapped. Incidental Medical and Dental: LPA reviewed 6 resident medications and there were no discrepancies observed. Residents with Special Health Needs : Facility accepts and retains residents with dementia. Staff are ensuring that incontinence residents are changed often and the facility remains free of odor from incontinence. There are no residents currently with prohibited or restricted health conditions. No residents are using oxygen equipment. A deficiency is issued on the LIC809D. An exit interview was held. A copy of this report along with appeal rights are given to Mr. Rabena.