Routine inspection·March 30, 2023

On 03/30/23, Licensing Program Analyst (LPA) Perry Scott conducted an unannounced annual required visit using the new Cares Inspection Tool. LPA met with licensee, Rukayat Adamson and explained the purpose of the visit. The facility is licensed to serve residents age range 60 and over, six (6) ambulatories, of which 6 may be non-ambulatory and a hospice waiver for 4. The current resident census is six (6). The facility has an outstanding balance of $742.00 for annual fees due, which include a late payment penalty. The facility is a single-story structure located in a residential neighborhood. It consists of the following: 5 bedrooms ( three (3) resident bedrooms and 2 staff rooms), (2) bathrooms ((1) staff and (1) resident bathroom), living room, dining room, kitchen, attached two car garage, and back yard patio with table and six chairs. Each resident bedroom has two residents residing. LPA toured the physical plant with licensee. 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 client 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 hot water temperature measured 109.3 degrees Fahrenheit. A comfortable temperature was maintained in the facility. 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 clients. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. LPA observed that the fire extinguisher was charged. The smoke detectors and carbon monoxide are operable. Fire Drills were observed to be maintained in order and accurate . Last fire drill was conducted on 3/14/23. Exits/ Walkways around the home were free of debris and hazards. Report continued on LIC809-C Medications were centrally stored and properly locked, first aid kit was checked and fully stocked with manual. Client and staff files were reviewed. All staff are fingerprint cleared and associated to the facility and have documentation of the required trainings on file. However, the staff member did not have a health screening in the personnel file and is being cited for that deficiency. LPA conducted a records review of (6) client records, (1) staff records, and reviewed the facility disaster plan. All client & staff records were complete, minus a health screening. The facility disaster plan was current and in compliance with Title 22 at the time of visit. LPA reviewed (6) Client Medication Administration Records and did not observe any discrepancies at the time of visit. 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 60-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. A review of staff and resident temperature logs were reviewed. The following deficiencies were cited during this visit: 87411(f) Personnel Requirements-General (No health screening for staff member) An exit interview was conducted, and a copy of this report was provided to Licensee, Rukayat Adamson