Routine inspection·July 18, 2024

On 07/18/2024 Licensing Program Analyst (LPA) Mario Leon held an unannounced, required, one (1) year visit to the above-mentioned facility using the CARE tools. LPA was met by Sonny Harris, Administrator (S1), and the purpose of the visit was explained. The facility is licensed to operate for six (6); of which one (1) may be bedridden, four (4) non-ambulatory and one (1) ambulatory elderly adult(s), aged 60 and over. On 10/16/2023 the department approved the above-mentioned facility to retain two (2) hospice residents. The facility is a single-story house, located in a residential neighborhood which consists of the following: five (5) bedrooms, and two (2) full bathrooms. There is one (1) living room, one (1) dining room, kitchen, washer/dryer area and an outside shaded area with umbrella, table and chairs. There is an attached two (2)-car garage. Of the five (5) bedrooms, four (4) of the bedrooms are reserved for residents and one (1) bedroom is used as the staff room. In addition, there is a one (1) shed located in the backyard. LPA and Administrator (S1) toured the inside and outside of the facility. All client rooms were checked. Mattresses and box springs were in good condition, adequate lighting was observed, plenty of dresser and closet space was observed. Bed linens, comforters and bath towels were adequately stocked at the time of visit. Bathrooms were found to be within Title 22 regulation. Toilets and water faucets worked properly. Shower was free of mold/mildew, with adequate lighting and sufficient toiletries were accessible to clients and were observed. The water temperature properly measured between 105 - 120 degrees F, within title 22 regulations.LPA observed the facilities screens to be in need of repair throughout the facility. See LIC809D. Food supply was checked and a 7-day of non-perishable and 2-day supply of perishable foods were adequately stocked during the time of today's visit. Carbon monoxide/Smoke detectors were observed and operational. Fire extinguishers were fully charged as of 07/12/2023, toxins and knifes were locked and inaccessible to clients. Medications were centrally stored and properly locked, first aid kit was checked and fully stocked. Last facility fire drill was conducted on 07/01/2024. LPA reviewed the facility disaster plan and the facility disaster plan was current and in compliance with Title 22. Report Continues, see LIC809C. An audit of residents #1-#5 (R1-R5) service files and medication administration record (MAR) and staff #1-#4 (S1-S4) personnel files revealed to be complete. There was one (1) deficiency cited during today's visit, see LIC809D. There has been one (1) Technical Advisory, Violation, cited during today's visit, see LIC9102-TV. An exit interview was held with Sonny Harris, Administrator, and a copy of the facilities' appeal rights, LIC809D, LIC9102-TV and this report has been provided.