Routine inspection·July 30, 2022

On 07/30/22, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced annual required visit with a primary focus on Infection Control measures using the new CARE Inspection Tool. LPA met with assistant administrator Anchie Reyes and explained the purpose of today’s visit. The facility is licensed to operate for six (6) non-ambulatory elderly residents ages 60 and above. The facility is approved for two (2) hospice residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: five (5) resident's rooms, two (2) common bathrooms, living area, dining area, kitchen, and outside covered patio area. LPA 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 106.9 F. A comfortable temperature of 73 degrees 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 were stored and not accessible to residents. The kitchen was inspected and there is sufficient perishable and non-perishable food available and maintained properly. The facility has two (2) fire extinguishers that were charged. A working landline telephone remains available. Evaluation Report Continues on LIC 809-C DEFICIENCIES: During a health and safety inspection, LPA observed at 3:20 pm a disinfectant solution under the kitchen sink, a butcher knife, and a sharp scissor inside the dishwasher accessible to residents in care. During record review, LPA observed resident #3 admitted on 06/14/22 as a hospice resident. This exceeded beyond the conditions and limitations specified on the license. The facility is licensed for (2) hospice waivers and currently, the facility is operating with (3) hospice residents in care. Due to time constraints, an annual continuation is required to complete a health and safety inspection and conduct Infection Control questionnaires. Deficiencies are issued and an exit interview is conducted with Anchie Reyes. A copy of this report is provided along with the appeal rights.