Routine inspection·November 13, 2023

On 11/13/2023 at 09:30 AM, Licensing Program Analyst (LPA) Christopher Alemoh conducted an unannounced Required – Annual Continuation Inspection and met with Asst . Administrator Asya Akopyana. Two (2) residents and One (1) staff were present during this inspection. Facility is licensed to serve six (6) non-ambulatory residents, two (2) may be bedridden in any room. The facility also has an approved hospice waiver for six (6) residents. The facility currently has (One) 1 non-ambulatory resident. Two (2) residents receive Hospice services, and one (1) resident is receiving Home Health Services. The Annual Licensing Fees are current. Required postings were observed in the entry area. The home consists of 1 floor level with: 1 staff room, 3 resident rooms, 2 restrooms, kitchen, dining room, and laundry room. The assistant administrator accompanied LPA inside and outside the facility during this inspection. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. There are no security bars or weapons on the premises. All windows have screens and Alarms due to Dementia residents. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place. The middle bathroom hot water temperature properly measured between 117.8-118.1F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards, doorways were free of obstructions. (Contd from 809) LPA toured the kitchen area and observed a two-day supply of perishable and a seven-day supply of non-perishable food. Properly stored between two refrigerators across from each other. Knives and toxics were kept in a locked storage cabinet. First Aid kit was available stored next to medication. One fire extinguisher, last serviced November 13, 2023, was observed in the kitchen area second fire extinguisher was observed in the entryway. LPA tested all carbon monoxide detectors and smoke detector located in the kitchen area. Both devices were functional. LPA observed that all bedrooms and hallways are equipped with a carbon monoxide and smoke detector. Two (2) staff records were reviewed, 2 out of 2 staff records had current first aid certificates and had required criminal record clearances or criminal record exemptions. Two (2) resident records were reviewed and 2 out of 2 client records had Admission Agreements, Medical Assessments, Pre-appraisals (or Reappraisals) and/or Needs & Services Plans, and CSMD Medication and Medication Records were reviewed for proper documentation. An exit interview was conducted, A copy of this report and appeal rights were discussed and left with Assistant Administrator Asya Akopyana.