Routine inspection·August 20, 2024

On 08/20/24, 10:15 AM, Licensing Program Analyst, (LPA) Raymond Comer, conducted an unannounced Annual visit to this facility. LPA met with Facility Administrator, Brian Rosales, and reason for the visit was discussed. Facility is licensed as a single-story residence, fire clearance for ten (10) non-ambulatory, and one (1) bedridden. Hospice waiver for eleven (11). Facility has eight (8) total bedrooms; seven shared and one private, and two (2) bathrooms. At 10:30 AM , LPA conducted a tour of the physical plant with the Administrator and observed the following: Physical plant was inspected for cleanliness and condition . Facility’s main door is the primary entry/exit access. Screening area is located immediately upon entrance. Auditory alarm sensors are present on all exits. Visitor Sign-in sheet, hand sanitizer, gloves and masks are available . Room temperature is comfortable; wall thermostat displays a setting of 75.0°F ., within the required range. An approved Mitigation and Infection Control plan is on file. Hand washing, coughing etiquette, and other necessary signage are prominently displayed throughout the facility. Required postings observed to be current. Disaster drills were last conducted in March, 2024. Fire Detection/Protection system is present in the facility. Multiple dual smoke alarm and carbon monoxide detectors are installed, hardwired, and interconnected. Detectors were tested and function properly. LPA observed Three (3) fire extinguishers located on the wall between the dining room and kitchen, behind the front door, and at the end of the hallway near rooms bedroom#7 and bedroom #8. Extinguishers display service date: 02/16/2024. [LIC 809C-continued] Kitchen: At 10:50AM, LPA observed kitchen as clean, equipped with a functional stove, multiple appliances, with an adequate supply of perishables and non-perishable food. Storage cabinets were observed to contain emergency dry food, condiments, and can goods. Food is observed as properly labeled and stored. Kitchen cabinets store dishes, plastic, paper goods and utensils. Knives and sharps are secured in a locked drawer and inaccessible to residents. Medications are stored in a secured medication cart in kitchen area and are inaccessible to residents. Medications are listed on a centrally stored medication and destruction record log. A First Aid kit is complete and stored inside living room cabinet. Laundry At 11:15 AM, LPA observed the hallway area. The laundry is located in the hallway, across from bedroom #3, and is secured by an electric rolling shutter activated by a key switch only accessible to staff. Laundry soaps and other cleaning agents are stored and inaccessible to residents. Hallway area storage cabinets were observed to contain fresh towels, linens and blankets, sufficient for residents. Commons: LPA observed all common areas of the facility, including the living room and resident dining area. Common areas were clean and organized. Furnishings provide adequate seating for residents and are in good condition. Activities were observed as stored in a cupboard section of the living room, along with arts and crafts, board games, puzzles etc. Bedrooms are observed as clean with sufficient lighting, properly furnished with sufficient closet space, bedding, linens, at least one chair, and night stand. Bathrooms were observed to be clean and sanitary with necessary supplies and required safety fixtures (grab bars, anti-slip floor stripping). Hot water temperature measured at 111.0°F. Within the required range. [LIC 809C-continued] Garage is detached from the house; observed to be locked by keypad-only entry, and inaccessible to residents. Garage is also used as storage for PPE supplies, incontinence supplies, wheelchairs, bedframes, emergency food, and other supplies for resident needs. Outdoor (backyard) area observed to have a shaded patio, with table with sufficient seating for the residents. Outdoor furniture observed to be in good condition. A locked shed in the backyard stores tools and maintenance supplies. All trash cans were observed to be covered. There are no bodies of water in the facility. Resident records: Secured cabinet in the kitchen area is locked and inaccessible to residents . A total of six (6) Resident files were reviewed for current IPP and/or Needs and Services plans, physician report, and admission agreements. Resident records appeared to be complete and current. Staff records: Secured cabinet in the kitchen area is locked and inaccessible to residents . A total of six (6) Staff files were reviewed. Criminal record clearances were present, and Staff are associated to this facility. Staff records appear to be complete and current. There were no immediate health and safety hazards observed at the time of this inspection. Exit interview conducted and a copy of this report was given to facility representative, Administrator Brain Rosales.