Routine inspection·August 21, 2022

On 08/21/22, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced annual required visit with a primary focus on Infection Control measures using the CARE Inspection Tool. LPA met with administrator Antonia Dionisio and explained the purpose of today’s visit. The facility is licensed to operate for (6) residents of which (5) non-ambulatory and may be (1) bedridden elderly residents ages 60 and above. The facility is approved for (1) hospice resident. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) residents' rooms, two (2) common bathrooms, a living area, a dining area, a kitchen, and an outside patio area. LPA toured the physical plant. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, and storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of the visit. Bathrooms were found to be operational. The water temperature measured 110.6 F. A comfortable temperature of 75 degrees was maintained in the facility. LPA observed the facility to be furnished at the time of the visit. Storage areas for personal hygiene and sharp objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. The facility has (1) fire extinguisher that is charged, and smoke detectors operable. A working landline telephone remains available. Evaluation Report continues LIC 809-C INFECTION CONTROL: During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. LPA observed staff wearing face coverings, LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. A review of staff tests and residents' vaccination along with daily temperature checks were conducted. The facility has an approved Mitigation Plan Report on file with CCLD. DEFICIENCIES: LPA identified the kitchen stove and overhead microwave filled with build up grease and food particles. LPA observed a twin size mattress obstructing the emergency exit passage in room #4.. LPA observed the garage cluttered with unused mattresses other furnishings with rodent droppings and ants. LPA identified staff #2 with an expired 02/13/22 CPR/First Aid. The facility does not have a current liability insurance on file. Deficiencies are issued and an exit interview is conducted with Antonia Dionisio. A copy of this report is provided along with the appeal rights.