Routine inspection·March 20, 2023

On 03/20/23, Licensing Program Analyst (LPA) Perry Scott conducted an unannounced annual required visit using the new CARE Inspection Tool. LPA met with licensee Edith Pacleb and explained the purpose of today’s visit. The facility is licensed to operate for (6) non-ambulatory elderly residents ages 60 and above. The facility is approved for (1) hospice resident. There are currently four (4) residents in the facility. The facility is a single-story structure located in a residential neighborhood. It consists of the following: (4) residents' rooms, (2) common bathrooms, living area, dining area, kitchen, and outside covered patio area. LPA and licensee 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 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 clean and operational. The water temperature measured 119.1 F. A comfortable temperature is maintained in the facility. Report continued on LIC809-C LPA observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, 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 was charged, smoke detectors, and carbon monoxide were operable. LPA reviewed Medication Administration Records (MAR) for four (4) residents they were accurate and maintained in order. A working landline telephone remains available. LPA conducted a records review of (4) client records and (5) staff records. All client & staff records were complete. The last fire/emergency drill was performed on 1/10/2023. All staff are fingerprint cleared and associated to the facility and have documentation of the required trainings on file. No deficiencies were cited during this inspection visit. An exit interview was conducted, and a copy of this report was provided to Edith Pacleb.