Routine inspection·August 9, 2022

On 08/09/2022, Licensing Program Analyst (LPA) Don Senaha conducted an unannounced annual required visit with a primary focus on Infection Control measures using the new CARE Inspection Tool. LPA was met by caregivers Armando Erni and Radmar Vistar and explained the purpose of today’s visit. The facility is licensed to serve six (6) elderly residents ages 60 and above. The facility has a hospice waiver for one (1) resident. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) resident's rooms, one (1) staff room, two (2) bathrooms, living area, dining area, kitchen, and outside shaded patio area. All four (4) residents were in the facility at the time of the visit and zero (0) on hospice care. LPA and caregiver Armando Erni toured the physical plant. There were no bodies of water or obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting provided, storage for resident personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulations and were operational. The water temperature did not meet Title 22 regulations and are cited on the D page. There is an attached garage accessible through the door prior to entering the facility or the front of the garage. There is also a refrigerator/freezer located in the back patio area for additional food storage. The washer and dryer are located in the garage next to the water heater. Evaluation Report Continues on LIC 809-C LPA observed the facility to be appropriately furnished at the time of visit. LPA observed cleaning supplies and toxins under the kitchen sink (see LIC 809D page). The kitchen was inspected and there is sufficient perishable and non-perishable food available and properly maintained. There are two (2) fire extinguishers fully charged with one in the garage and the other in the kitchen area. Smoke detectors and carbon monoxide were tested and operational. A review of Medication Administration Records (MAR) was maintained in order and accurate. There was a first aid kit available stored in the kitchen. During the visit, LPA observed the facility infection control practices. LPA observed screening protocols for visitors, staff, and residents, sanitizing stations in common areas and restrooms. LPA observed all mandated inspection control posters were posted. Advisory Notes – Three (3) Technical Assistance were issued, please see LIC9102-AN. There were five (5) deficiencies cited during this inspection visit. See 809D page and Case Management D page. An exit interview was conducted and a copy of this report was provided to caregiver Armando Erni.