Routine inspection·January 16, 2025

Licensing Program Analyst (LPA) Gary Tan conducted an unannounced Required One () year inspection to this facility. LPA initially met with Administrator Monique Lopez and explained the purpose of the visit. At 10:25 AM, with the Administrator, LPA conducted a tour of the facility inside and out. The following were observed: There is one main entrance being utilized at the facility. Screening area is located in the reception area. Sign in log book, hand sanitizer and masks are available. The facility had submitted and approved Mitigation Plan and Infection Control Plan. Signs to wear a mask and other COVID-19 prevention protocol signs were posted indoors. Hand washing, coughing etiquette, physical distancing and other necessary signage were posted in the bathroom and all over the facility. The facility has a designated visitor's area in the front of the main building. The facility has sufficient stock of PPE in the storage room The facility consists two (2) storey building and a basement. The facility is fire cleared for 128 ambulatory residents, sixty (60) of which maybe non-ambulatory. Hospice waiver for twenty five (25) residents. The basement has the Kitchen, Cafeteria, Activity room, Laundry Area, Staff break room and Storage rooms. There are sixty four (64) shared bedrooms with own bathroom and eight (8) public bathrooms. There were two (2) shaded smoking area in the surrounding backyard equipped with outdoor furniture. There is no body of water in the facility. (continued to LIC 809-C) (continued from LIC 809) Common Areas: The facility has two (2) elevators, both of which are working properly. The facility maintains a comfortable temperature at 75°F. The facility's smoke alarms are hard wired and interconnected and back up and tests are done in house on April 2024. The facility is equipped with sprinkler system which was last tested on 04/20/24 and valid until 04/30/26. Fire extinguishers are located all throughout the facility and were last serviced on 10/18/24. Fire Drill was last conducted on 01/03/25. Personal accommodations in resident bedrooms and bathrooms were observed for safety, privacy, and comfort. Random resident rooms were inspected and observed with all required furnishings, working signal system, grab bars and nonskid surfaces in the bathrooms. Hot water temperature in random resident bathrooms were checked and measured a range of 109.2°F to 114.4°F. There were enough clean linen available. Basement: Kitchen and Cafeteria are located in the basement area the kitchen appeared clean, odorless and free from insects. Kitchen is sufficiently stocked with at least two (2) days perishable and seven (7) days non-perishable foods. Frozen foods are wrapped and stored appropriately. Kitchen was observed to be inaccessible to residents. LPA observed however that the lunch being served is not the one on the menu for the day and there is no activity calendar posted anywhere in the facility. Laundry room is located in the basement and was observed to be locked during visit. At 2:35 PM, LPA reviewed records of six (6) random residents and six (6) staff. Resident and staff records appeared to be complete and updated. Medications were observed to be locked in the medication room and inaccessible to residents. There were two ( 2) complete first aid kits in the medication room. Citation issued. Appeal rights discussed and given. Exit interview conducted. Copy of this report issued.