Routine inspection·December 17, 2023

On 12/17/23, Licensing Program Analyst (LPA) Antonine Richard conducted an unannounced annual required visit using the new CARE Inspection Tool. LPA was met by caregivers Carmencita Yap and Radmar Vistar and explained the purpose of today’s visit. Later was joined with Noemie Bunag. 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 Richard and caregiver Radmar Vistar 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 hot water temperature tested 107. 2F and 106. 5F. 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. 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. There were two (2) deficiencies cited during this inspection visit. An exit interview was conducted and a copy of this report and appeal rights were provided to administrator Noemie Bunag