Routine inspection·May 14, 2025

On 05/14/2023 at 1:20 p.m. Licensing Program Analyst (LPA) Evelin Rios arrived at the facility listed above to conduct an unannounced annual inspection using the CARE Inspection Tool. LPA was greeted and granted access by staff #1 (S1). LPA observed appropriate postings upon entry. S1 contacted the the Administrator, Renelyn Landicho. LPA met with administrator shortly after. LPA explained the reason for the visit. At 1:28 p.m., LPA Rios and the administrator conducted a physical plant tour of the facility inside and out and the following was observed: Bedrooms: LPA inspected six (06) out of six (06) for resident bedroom. LPA observed each resident bedroom to be properly furnished and have sufficient lighting and storage. Bathrooms: The facility has three (03) total bathrooms one (1) of which is located in the shared bedroom. LPA took hot water temperature from two (02) out three (03) bathrooms. At 1:49 p.m. the temperatures ranged from 107.8 and 107.4 degrees Fahrenheit, within regulation. LPA observed the bathrooms to be clean and properly supplied with toilet paper, paper towels, and hand soap. LPA observed a closet by the bedrooms with emergency food. Laundry/Garage: Laundry room is kept locked and is a passageway to the garage. Detergents and cleaning chemicals are kept locked in the laundry room. LPA observed a washer and dryer and extra clean linens. Garage is not accessible to residents. In the garage LPA observed a second fridge with extra food stored for residents. By the laundry room LPA observed a fully stocked first aid kit and manual. (Cont. on LIC809-C) (Continued LIC809-C) Living room: The living room was clean and properly furnished. There is a television and seating for the capacity of the facility. On two (02) sliding doors LPA observed mechanisms used to keep the doors locked when the sliding doors already have a lock on the door handle. Although the mechanism is able to open without a key the facility has has three (3) non ambulatory residents. The administrator removed both mechanism immediately. Surrounding Grounds : There is a covered patio and appropriate furniture for residents to use. LPA observed a locked shed being used for storage. Side gate was checked to insure it was clear of obstruction. There are no bodies of water. Kitchen/ Dinning area: The kitchen was observed to be clean and clear of clutter. Appliances and fixtures were functioning properly. LPA observed knives and sharps locked in drawer. LPA observed a sufficient amount of 2- day perishable and 7-day non-perishable food at the facility, properly stored. Dining area had appropriate table and chairs to sit the capacity of the facility. Resident/Staff Records: From approximately 1:56 p.m. to 4:10 p.m. LPA reviewed six (06) out of (06) resident records and three (03) staff records. Records were observed complete, up-to-date and in compliance with licensing forms. LPA reviewed the facility's Infection Control Plan, Emergency Disaster Plan (LIC610E) and Liability Insurance, documents were reviewed by the administrator and up-to-date. Facility last conducted a Disaster Drill on 04/04/25 and a Fire Drill on 04/09/25. Medications are centrally stored and maintained locked in a designated cabinet located in the laundry room. Medications were observed locked. Centrally Stored Medication Records are filled in manually and facility keeps a Medication Administration Record (MAR). LPA observed one (02) fire extinguishers fully charged one was last serviced on 08/15/2024 and the other was purchased on10/15/2024. At 4:25 p.m. LPA observed the administrator test a dual smoke and carbon monoxide detector. Detectors are hardwired and interconnected to other detectors located through out the facility. Detectors were observed to be functioning properly. There is a fire door leading to the bedrooms that automatically closed during the test. Deficiency cited and cleared on todays visit. Exit interview conducted. Copy of report provided.