Routine inspection·February 15, 2022

On 02/15/2022, 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 met with Administrator Antonia Dionisio and explained the purpose of today’s visit. The facility is licensed to operate for six (6) elderly non-ambulatory residents ages 60 and above. Facility is approved for one (1) hospice. The facility is a single-story structure located in a residential neighborhood. It consists of the following: four (4) resident's rooms, two (2) bathrooms, two (2) living areas, dining area, kitchen and outside covered patio area with a table and chairs. There is an attached garage with access only through the garage door used for storage. The washer and dryer for laundry is located next to the kitchen area. LPA and Administrator 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 clean and operational. The water temperature measured between 112.8 F and 118.6 F in the bathrooms and kitchen. 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 residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available maintained properly. One (1) fire extinguisher were fully charged next to the kitchen, smoke detectors and carbon monoxide were operable. First aid kit is available where the medications are stored in the kitchen area. Evaluation Report Continues on LIC 809-C 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 staff were wearing face coverings. All mandated inspection control posters were posted. One Advisory Note - Technical Assistance was issued, please see LIC9102-AN. One deficiency was cited during the visit. See D page. An exit interview was conducted, and a copy of this report was provided to Administrator Antonia Dionisio.