Routine inspection·May 21, 2025

At 12:30 p.m., Licensing Program Analyst (LPA) Evelin Rios arrived at the above mentioned facility to conduct an unannounced annual inspection. LPA was greeted by Licensee, Josephine Miranda and staff #1(S1). LPA explained the reason for the visit. An entrance interview was conducted. At 12:45 p.m., LPA toured the facility inside and outside and observed the following: Upon entry LPA observed appropriate postings except for the Complaint Poster (PUB 475) or a poster created by the facility with the same information. LPA provided a an email link to PUB 475 to Licensee. The facility has six (06) total bedrooms and three (03) total bathrooms. Five (05) out of the six (06) bedrooms are for residents' use of which one (01) is shared. Bedrooms have appropriate furniture such as beds, night stands, chairs and enough storage for residents' belongings. In bedroom labeled 4, LPA observed an extra bedframe with mattress leaning against the wall on the left side of the resident's bed. According to Josephine the resident would be transferred to the newer furniture and a company would be by to pick up the extra furniture. LPA observed auditory alarms on exit doors working properly. Bathrooms were observed clean and were supplied with toilet paper, hand soap, paper towels, grab bars by toilets and showers and showers had non slip flooring. In the shared bathroom LPA observed boxes of incontinent care stacked on top of each other blocking access to a shower. Licensee stated she and S1 would be moving the boxes to a storage area tonight. At 3:22 p.m. LPA tested the hot water temperature in one (01) bathroom and it read 110.7 degrees Fahrenheit, within regulation. (Continue to LIC809-C) (Continued from LIC809) The laundry room was observed locked and leads to the attached garage . In the laundry room LPA observed a washer and dryer. The facility keeps cleaning supplies and detergents locked in the garage. Common areas include the living room, dining area and backyard. In the living room LPA observed a television with appropriate furniture that sits the capacity of the facility. Dining areas had appropriate tables and chairs. LPA observed two (02) facility telephones, operational. The backdoor in the living room area leading to the backyard is missing a door knob. The facility has attached two strings, one on the inside of the door and the other on the outside to open and close the door. According to the Licensee she is working on getting it fixed. The backyard is fenced in and LPA observed a covered patio with outdoor furniture and a shed that is kept locked. Outside LPA also observed a refrigerator used to store extra food and a non working refrigerator, washer and dryer. According to Josephine the appliances are used for storage but will be working on removing them from the property. Exits and passageways were observed free of obstructions. The kitchen was observed to be clean and clear of clutter. Appliances and fixtures were functioning properly. There is a one (01) week supply of nonperishable, and two 02) day supply of perishable food. LPA observed one (01) fire extinguisher fully charged. LPA observed a first aid kit and resident medications in a locked kitchen cabinet. At 2:30 p.m., LPA reviewed four (04) of four (04) resident records and two (02) staff files. At 3:30 p.m., LPA reviewed residents medication and centrally stored medication and destruction records. Medication records for centrally stored medications had not been updated for the month of May 2025 and did not accurately reflect the medication stored for three (03) out of four (04) residents. Licensee stated they were unable to renew the facilities lability insurance. Licensee provided information to change administrator. Deficiencies were observed, refer to (LIC809-D). An exit interview was conducted. Appeal rights provided. A copy of this report was signed and delivered.