Routine inspection·November 4, 2024

Licensing Program Analyst (LPA) Mariana Agban conducted an Annual Required visit and inspection of the facility. LPA met with staff 1 (S1) and explained the reason for the visit. Administrator, Florence Peregrino had arrived shortly after. At approximately 10:15 am, with the assistance of staff 1 (S1), LPA took a tour of the physical plant. Required postings were observed in the entry area. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives were stored in a locked drawer in the kitchen. Properly labeled medications were locked in one of the kitchen cabinets. The laundry area is located through the kitchen. The washer and dryer were observed to be in good condition. Bedrooms: There were five (5) bedrooms designated for residents' use. Four (4) bedrooms are designated for private use, and one (1) room is shared. All five bedrooms, in use by residents, were properly furnished with appropriate beddings and linens with sufficient lighting. Bathrooms: There were four (4) bathrooms in the facility. One (1) bathroom in hallway and three (3) bathrooms in the private bedrooms. All bathrooms were clean, properly supplied and had functional fixtures. Hot water temperature was 115.6 degrees Fahrenheit. Cleaning supplies were kept in locked cabinets. Temperature: Facility maintains a comfortable temperature of 78 degrees Fahrenheit. S moke Alarms and Carb on Monoxid e : detectors were tested and function properly. Fire extinguisher is located in the kitchen with purchase date 11/4/24. Common Areas : These included the living room and dining area. The common areas were properly furnished with adequate couches, chair, and television. The dining area had a large table, to seat up to six (6) individuals. Furniture in common areas were clean and in good repair. Floors were mopped and clean. Hallways and passageways were clear of any obstruction. Surrounding Grounds : Entry/exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. No lock on the side g ate. There was furniture appropriate for outdoor use. The backyard has sufficient space to hold outdoor activities. There are no pools or any other bodies of water. Resident Files : LPA conducted a file review of resident records to ensure compliance of licensing forms. Staff Files : LPA was unable to conduct staff file review as there was no physical file for S1, S2 and S3. Medications : Medication and Medication Records were review for proper documentation. Exit interview conducted, citation issued and copy of this report signed and delivered.