Routine inspection·June 22, 2024

On 06/22/24 at 12:15 PM, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced required – annual inspection and met with Administrator/House Manager Kristine Simonian . The facility is licensed to operate for six (6) residents ages 60 and over of which six (6) may be non-ambulatory. The facility is approved for three (3) hospice residents. The facility is a single-story structure located in a residential neighborhood. It consists of the following: five (5) resident bedrooms, two (2) bathrooms, living area, dining area, kitchen, side patio, and (2) outside covered patio area. The facility is clean, sanitary, and in good repair. Staff accompanied LPA inside and outside the facility during this inspection. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. There are no security bars or weapons on the premises. Bathrooms were checked. Toilets and water faucets worked properly, shower was free of mold/mildew and non-skid strips was in place, hot water temperature properly measured between 109 degrees F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards and doorways were free of obstructions. LPA toured the kitchen area and garage and observed a two day supply of perishable and a seven day supply of non-perishable food. The facility cater in lunch 4-5 times during the weekday. Knives and toxins were kept in locked storage cabinet. First Aid kit was available. One fire extinguisher, last serviced January 12, 2024 was observed in the hallway near the outdoor exit. Continue to LIC809-C. Administrator tested the carbon monoxide detector and smoke detectors in the house. Devices are interconnected and operational. 5 staff records were reviewed. 5 resident records were reviewed and, 5 out of 5 resident records had medical assessments and pre-appraisal or reappraisals. Two residents’ medication was reviewed. No deficiencies are being cited. An exit interview was conducted, technical assistance provided, and a copy of this report was discussed and left with Administrator Kristine Simonian .