Routine inspection·January 31, 2024

On 01/31/23, Licensing Program Analyst (LPA) Mario Leon conducted an unannounced annual required visit using the CARE Inspection Tool. LPA was met by Administrator, Maria Tavarez, to explain the purpose of today’s visit. The facility is licensed to operate for six (6) non-ambulatory residents ages 60 and over and has an approved hospice waiver for two (2) residents. The facility is a single story, 5 bedrooms which 4 bedrooms are for residents and 1 bedroom is for live-in staff, 2 common restrooms, 1 private restroom, one (1) laundry room, dining area, living room with staff computer, kitchen, pantry, linen closet, a designated outdoor shaded area and a detached garage that stores a freezer and additional food, paper and hygiene products. The facility water temperatures measured between 105 and 118 degrees F. The facility has a working landline telephone. LPA toured the physical plant. There were no bodies of water or obstructions on the premises. Resident rooms were inspected, beds and bedding supplies were in good condition and adequate lighting was provided. Adequate storage, for the client's personal belongings, was observed. Bed linens, comforters, and bath towels were adequately stocked during the visit. All bathrooms were found to be within Title 22 regulations and were clean and operational. LPA observed the facility to be mostly sanitary and appropriately furnished at the time of visit. LPA observed the Southern facing screen, located in the kitchen, is in disrepair and needs to be re-screened, see LIC809D. All storage areas for personal hygiene, toxins, and sharp objects were stored and not accessible to residents. LPA observed one cleaning product left accessible in the laundry room, see LIC9102TV. LPA reviewed Medication Administration Records (MAR) which revealed to be accurate and maintained in order. The kitchen was inspected and sufficient perishable and non-perishable food was maintained adequately. One (1) fire extinguisher was charged as of 03/09/23. Smoke detectors and carbon monoxide were in working condition and the last fire drill was conducted on 01/03/24. Report continues, see LIC809C. During the visit, LPA observed the facility's infection control practices. LPA observed there were screening protocols for visitors, staff, and residents, sanitizing stations with paper towels in common areas and restrooms. LPA observed staff wearing face coverings, LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. The facility has an approved CCLD Mitigation Plan. LPA observed the facilities' Surety Bond, validated through Rimkin Co, Inc., provided on 06/30/23 which covers $2,000 per instance. LPA also observed property insurance, validated through Rimkin Co, Inc. There was one (1) deficiency cited during today's inspection and a plan of corrections were created with Administrator, Maria Tavarez. See LIC809D. There was one (1) technical violation note provided during today's inspection and a copy was provided to Administrator, Maria Tavarez. See LIC9102TV. An exit interview was conducted with Administrator, Maria Tavarez. One (1) deficiency LIC809D, one (1) LIC9102TV, and a copy of the appeal rights and this report were provided to Administrator, Maria Tavarez.