Routine inspection·January 7, 2024

Licensing Program Analyst (LPA) Gary Tan, met with co administrator Errol Fernando for a One (1) Year Required visit for this facility. LPA explained the reason for the visit. A tour of the physical plant was conducted at 1:52 PM and the following was noted: There is only one entrance being utilized at the facility, there are required poster posted at the main door. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available. The facility had submitted and approved Infection Control and Mitigation plan. Signs to wear a mask and other Covid 19 prevention protocol signs were posted outside and inside. Hand washing, coughing etiquette, physical distancing and other necessary signs were posted in the bathroom and all over the facility. The facility has a designated visitors' area at the backyard. The facility has sufficient stock of PPE in the storage room. The facility has four (4) bedrooms and three (3) bathrooms currently occupying four (4) residents. The facility is fire cleared for three (3) non-ambulatory residents one (1) of which may be bedridden on Room #1 and three (3) ambulatory. Hospice waiver for six (6) residents Living and dining room furniture were also checked. The living room is neat and clean. The facility maintains a comfortable temperature at 75°F. The smoke detectors are hardwired and interconnected and observed to be operational. There is a carbon monoxide installed at the facility. Fire extinguisher is located in the dining area and observed to be full and last inspected on 07/25/23. The backyard of the facility has outdoor furniture, with a covered shaded area for clients. There is no body of water in the facility. (continued on LIC 809-C) (continued on LIC 809-C) The garage is attached to the house. The garage is currently being used as staff rest area and storage for old equipment, frozen foods, PPE and other toxins. Laundry room is located on a small room on the way to the garage, Laundry detergents, cleaning agents and other toxins are stored in a locked cabinet in the laundry area. The laundry room was observed to be locked during visit. Food Service/Kitchen area was sufficiently stocked with two (2) days perishable and seven (7) days non-perishable food. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Knives and sharps are observed to be locked in a kitchen drawer and inaccessible to residents. The Clients' rooms are adequately furnished with appropriate furniture and lighting system. Hall ways/passage ways are lit. Clients have sufficient amounts of personal hygiene product which is provided by the licensee. The bathroom was checked for cleanliness and proper operation. LPA observed the appropriate grab bars in the toilet and shower. The hot water temperature was measured at 112.5°F. Towels and washcloths are not shared. There was enough clean linen available in stock at the cabinet. Medications : LPA observed medication in the dining area cabinet to be locked and inaccessible to residents. There were two (2) complete first aid kits located in the medication cabinet. Client records : Client records are reviewed. Residents record appeared to be complete and current. Staff records : LPA conducted a complete file review of staff records. Staff records appeared to be complete and updated. Disaster drill was last conducted on 11/28 /23 . Required posting observed in facility (complaint hot line poster). Exit interview conducted. Copy of this report issued.