Routine inspection·February 7, 2024

Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an annual required visit and inspection of the facility. At 10:11 am Chinweike Okonkwo who is the administrator met with LPA, explained the reason for the visit. At 9:36 am, with the assistance of staff, LPA took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms are operational that are located each bedroom, the hallway and kitchen. There are carbon monoxide detectors that functions properly. The fire extinguisher is in the kitchen. The charge date of 2/7/2024. During the visit the facility is at 73 degrees Fahrenheit. The facility is fire cleared for six (06) non-ambulatory residents. Facility has two (2) hospice waiver. Facility has no issue with fire clearance. Kitchen: The kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPA found enough at least two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. Frozen foods are wrap, dated, and stored properly as well. Knives were stored in a locked cabinet in the kitchen. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers. Cleaning supplies, pesticides or toxic cleaning supplies were stored and locked away in the kitchen. Bedrooms: There were five (5) bedrooms in the facility. Bedroom #1 is for staff used. Bedroom #2 is for private resident used. Bedroom #3 , Bedroom #4 and bedroom #5 are shared bedroom for residents, but bedroom #4 is empty right now and bedroom #5 has only one occupant. All of the bedrooms are used by residents were properly furnished with appropriate dresser, beddings, and linens with sufficient lighting. Continue to LIC 809-C Bathrooms: There are two (2) bathroom in the facility, but only one (1) bathroom is designated for residents' use. The bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured at 116.2 degrees Fahrenheit for bathroom #1 located in the hallway across bedroom #3. Bathroom #2 is inside staff bedroom for private used. There was enough clean linen available in the cabinets in the hallway. Common Areas: LPA toured all common areas of the facility. These included the living room and dining area for residents. The common areas were properly furnished. Residents dining table fits enough for six (6). LPA observed common areas to be very clean and tidy. LPA observed the floors to be in very good condition. No obstructions and or tripping hazards throughout the facility. Furniture in common area was observed to be in good repair. Infection control : Facility mitigation plan to make sure licensee was following current infection control recommendations. LPA obtain a copy and reviewed the infection control plan during this visit. Surrounding Grounds : Entry and exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. The facility does not have a swimming pool or body of water. There is no garage in the facility, only car ports. Fire place is closed and non-operational. Laundry service: There is enough linen available to change weekly or more if need. Cleaning supplies are being stored in a locked cabinet in the kitchen area. Staff Files : LPA also conducted a file review of staff records to ensure forms and training are up to date and compliance with licensing forms. Office space is beside the common area by the entrance of the facility. Records were checked for expired or missing certificates and clearances: LPA conducted a file review of staff for criminal record clearances and current First Aid. The administrator file was reviewed for current first aid, fingerprint clearance, administrator certificate, and HIV/AIDS and TB training. Continue to LIC 809-C Medications are in a centrally stored and locked place, including over-the-counter medicines; medications are properly labeled and checked for expiration dates. Each centrally stored prescription and PRN medication has been logged in the medications log with proper documentation from the clients’ doctor. Proper medication dispensing instruction are followed and checked for contamination. First-aid has all proper items and is current. Resident records were reviewed for requirements and legibility: LPA reviewed client’s files for current appraisals 1 out of 4 is incomplete. Also, 1 out of 4 physician report is not filed. Liability insurance copy was handed to LPA. Planned activities are offered. Under Title 22, Division 6, Chapter 8, the following citations were issued and recorded on LIC809-D. No other health and safety hazard is noted. Exit interview was conducted; appeal rights were discussed and copy of report was issued.