Routine inspection·October 12, 2023

Licensing Program Analysts (LPA) Emily Peraldi and Brian Balisi arrived at the facility unannounced to conduct a required annual visit. At 10:15 a.m., the LPAs met with the Administrator and explained the reason for the visit. At 10:42 a.m., the LPAs along with the Administrator, toured the physical plant areas inside and outside to ensure there are no health and safety hazards and that the facility is in compliance with Title 22 Regulations. KITCHEN: The LPAs observed the kitchen/dining area. Knives are stored in the inaccessible kitchen. Kitchen appliances appear to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food. At 10:52 a.m., hot water measured at 117.1-degree Fahrenheit. BEDROOMS: The LPAs observed nine (9) resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. Inside temperature was maintained at a comfortable level. RESTROOMS: Restrooms are relatively clean and sanitary and in operating condition with grab bars and non-skid mats. Between 10:48 a.m. and 11:30 a.m., hot water measured between 105.4 and 117.1-degree Fahrenheit. The sinks had sufficient liquid soap, and paper towels. OUTDOOR SPACE: At 10:53 a.m., the LPAs observed the back and front of the facility which has a covered outdoor area for resident use. There is a gate on the side of the facility designated for an emergency exit. There are no bodies of water on the premises. The facility only has a parking lot, no garage nor basement. Continued on LIC 809-C. COMMON AREAS: The LPAs observed common area to be relatively clean and properly furnished. The LPAs observed the fire extinguisher to be fully charged and last serviced on 10/05/2023. Signs are posted throughout facility to promote handwashing, and cough/sneeze etiquette. Fire alarm, fire sprinklers and fire doors were observed and passed by the Fire Department. Cleaning solutions, toxins, chemicals and hazardous items were inaccessible and locked away in the janitor closets and storage. Medications and first aid kits are located in a locked medication room. Laundry units and additional linens are located inside laundry room. RECORD REVIEW: Starting at 11:30 a.m., the LPA conducted a file review for all residents and staff. Staff records were reviewed for documents including, but not limited to health screening, TB test, staff training records, and fingerprint clearance. All files were in order. The Administrator’s Certificate expires 01/31/2024. The LPA reviewed resident records for nine (9) out of sixty-nine (69) residents. Resident’s records were reviewed for, but not limited to care plans, medical records, admissions agreement, and consent forms. All files were in order. Additionally, the LPAs received a copy of valid liability insurance and Facility Disaster Emergency Plan. Between 11:19 a.m. and 11:46 a.m., the LPA conducted interviews with six (6) staff and eight (8) residents. Between 1:50 p.m. and 2:15 p.m., the LPA conducted a review of medication and medication documentation with Medication Technician for six (6) residents and observed all medications were properly documented and assisted with as prescribed. No deficiencies cited at this time. Exit interview conducted. A copy of the report was provided.