Routine inspection·December 12, 2024

On 12/12/2024 at approximately 09:40 AM, Licensing Program Analyst (LPA), Angelica Segovia conducted an unannounced annual visit to the facility. Upon arrival LPA was greeted by Caregiver Myriam Reina. LPA stated the reason for the visit. The Administrator James Durando along with House-Manager Nancy Magallanes arrived shortly after to assist with today's visit. LPA asked for census, staff, and resident files…. LPA conducted a physical plant tour at approximately 11:00 AM and the following was noted: There is only one entrance being utilized at the facility. The facility is a single unit building with five (5) bedrooms and two (2) bathrooms currently occupying four (4) residents. One (1) room is designated for staff use only. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available. Required postings such as Emergency Disaster Plan, See/Say Something, Long-Term Ombudsman were located alongside reception desk within the living room. Common areas observed to be neat, clean, and organized. Common areas observed to be properly furnished and in good repair. The facility maintains a comfortable temperature at 70°F. Fire extinguisher located near the kitchen and dated 05/30/24. The kitchen observed to be fully stocked with two (2) days perishable and seven (7) days non-perishable food. Kitchen observed to be clean and inaccessible to pests. Knives and sharps observed to be locked alongside medication in a kitchen cabinet inaccessible to residents. Stove observed to be working and in proper condition. Small dining table located in the kitchen observed to be neat, clean, and properly furnished. (continued on LIC 809-C) The backyard of the facility is equipped with a designated shaded area with outdoor furniture for residents. There is no body of water in this facility. Smoke detectors and carbon monoxide observed to be working properly and were tested. The laundry room is located along the hallway leading towards the bedrooms. Laundry room observed to be locked and inaccessible to residents. Laundry detergents, cleaning agents, and other toxins are stored within laundry room and are locked inaccessible to residents. The Residents' rooms are adequately furnished with appropriate furniture and lighting system. Hallways/passageways are lighted appropriately. Residents have sufficient personal hygiene product which is provided by the licensee. The bathrooms were checked for cleanliness and proper operation. The hot water temperature was measured at 115.3°F. Towels and washcloths are not shared. Sufficient availability of clean lien and extra PPE stored in hallway cabinet. Appropriate grab bars and skid mats observed. Medications: LPA observed medication stored in kitchen cabinet locked and inaccessible to residents. Medication usage recorded and stored properly. LPA along with Administrator Durando conducted a review of the medication to ensure compliance. First-aid kit observed to be equipped with but not limited to bandages, scissors, digital thermometer, tweezer, and manual. Resident records: LPA conducted a complete file review of resident records. Resident records appeared to be complete and updated. Staff records: LPA conducted a complete file review of staff records. Staff records appeared to be complete and updated. An exit interview was conducted, One (1) citation issued for Liability Insurance not being readily available and/or expired. Appeals rights and a copy of this report was given to the Administrator.