Routine inspection·June 2, 2022

At 11:30am Licensing Program Analyst (LPA), Angela Panushkina, conducted an unannounced annual inspection at the facility mentioned above. LPA was greeted by Lorena Eusebio, who granted access to the facility and LPA explained the reason for the visit. At 11:35pm, LPA conducted a tour of the facility and the following was observed: Infection control: LPA reviewed the facility mitigation plan (approved on 04/11/2021) to make sure licensee was following current infection control recommendations. Upon arrival, LPA was screened and asked to sign-in the visitors’ log. In addition, LPA was asked all infection control questions. Proper signage was observed inside along the hallway and in the restrooms. Hand sanitizer was also observed. Staff stated they have sufficient PPE supplies for residents and staff. LPA observed all trash can throughout the facility missing lids. Kitchen: LPA toured the kitchen area and observed enough supplies of staple non-perishable for minimum 1 week and perishable for 2 days at the facility. All knives and sharps are observed to be locked in a kitchen drawer and inaccessible to residents. Medications: At approximately, 11:40am LPA observed medications are centrally stored and locked in the closet, by the kitchen area and inaccessible to residents in care. Bedrooms: There are four (4) bedrooms designated for residents use and have sufficient lighting. All bedrooms are properly furnished, clean and have appropriate bedding and linens. Auditory alarms were tested and observed to be operational. Bathrooms: At 11:55am LPA observed all bathrooms are clean and in good repair. Properly supplied with Continue on LIC809-C toilet papers, soap and paper towels. The hot water temperature measured at 108.0°F. LPA observed appropriate grab bar and non-skid mats. LPA observed appropriate hand washing signs posted in each bathroom. Smoke detectors/carbon monoxide . Dual smoke and carbon monoxide detectors were located throughout the facility, and at 12:00pm they were tested and observed to be operational. Common Areas : The facility maintains a comfortable temperature at 77°F. The living room and dining area appeared clean and were properly furnished. No obstructions and or tripping hazards throughout the facility. There is a fire extinguisher by the kitchen area and it was last serviced on 03/05/2020. Outside areas: At approximately, 12:10pm LPA toured the outside area of the facility. LPA observed appropriate outdoor furniture, with a covered shaded area for residents. LPA discussed the importance of maintaining the care and supervision to meet the needs of residents. There are no bodies of water. The garage: Laundry area is located in an attached garage and kept locked and inaccessible to residents. Extra PPE supplies and food storage was also observed. Administrative: LPA collected Certificate of Liability Insurance and LIC.500. Following citations Civil Penalty for $500 issued for the identified deficiencies pursuant to Title 22 Regulations on LIC809D. Exit interview conducted, appeal rights discussed and a copy of this report provided to the Administrator.