Routine inspection·July 8, 2022

On 07/08/22, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced annual required visit with a primary focus on Infection Control measures using the CARE Inspection Tool. LPA met with administrator Shalani Ramos and explained the purpose of today’s visit. The facility is licensed to operate for (1) non-ambulatory and cleared for (5) bedridden elderly residents ages 60 and above. The facility is approved for (6) hospice residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: five (5) resident's rooms, two (2) common bathrooms, living area, dining area, kitchen, and outside covered patio area. LPA toured the physical plant. There were no obstructions on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was 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 measured 111.6 F. A comfortable temperature of 64 degrees was maintained in the facility. LPA observed the facility to be appropriately furnished at the time of visit. Storage areas for personal hygiene, and sharps objects were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. The facility has (1) fire extinguisher that is charged, smoke detectors operable. A working landline telephone remains available. Evaluation Report continues on LIC 809-C DEFICIENCIES: LPA observed at 10:32 am an unpresentable bathroom #1 and #2. At 10:40 am, LPA observed the kitchen area in an unpresentable condition. At 12:00 pm, LPA observed a non-working carbon monoxide. The facility failed to conduct fire drills on a quarterly basis. The facility did not have Medication Administration Records for resident #4 who is receiving PRN medications for July 2022. INFECTION CONTROL: During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, sanitizing stations in common areas and restrooms. LPA observed staff were wearing face coverings, LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. A review of staff tests and residents' vaccination along with daily temperature checks were conducted. The facility has an approved Mitigation Plan Report on file with CCLD. Deficiencies are issued and an exit interview is conducted with Shalani Ramos. A copy of this report is provided along with the appeal rights.