Routine inspection·May 11, 2023

Licensing Program Analysts (LPAs) Alberto Lopez conducted an unannounced annual visit using the Care Evaluation Tool. LPA met with Staff Martha Guzman and explained the reason for the visit. Administrator Richard Villaverde joined LPA later and assisted with the visit. Physical Plant was toured. The facility is licensed for fifteen (15) residents over the age of 60 . The facility is a single-story building. LPAs toured the home and inspected nine (9) resident bedrooms, two (2) staff rooms 3.5 bathrooms, kitchen, dining room, living room, office, storage room, and laundry room. Infection Control: The facility staff are using appropriate hand hygiene and gloves while assisting residents and medications. Disposals of trash are done immediately. Staff are still cleaning and disinfecting throughout the day. Facility has sufficient PPE supplies and has Infection control plan at facility. Physical Plant & Environment Safety: . There are 9 client bedrooms, 6 shared rooms 3.5 bathrooms, 3 with showers, living room, activity room, dining room, kitchen, laundry room. Facility has operable smoke and carbon monoxide combo detectors located in hallway and was tested. Knives, cleaning solutions, and disinfectants are locked in the cabinets. No firearms or weapons are stored at the facility. LPA measured the hot water temperature in the bathrooms and kitchen sink. The hot water temperature in measured 109.4 – 109.5 degrees F which is within the required range of 105-120 degrees F. Facility roof is in need of replacement. Operational Requirements The licensee provides care and supervision as required. Plan of operation was at facility for inspection. Staffing : There appears to be sufficient staffing at the facility. The administrator’s certificate expires 06/09/2023 Staff employed are all over the age of 18. Planned Activities: Facility staff encourage residents to participate in activities. Resident Rights/Information: Resident rights are posted at facility and staff are familiar with resident rights. Personnel Records-Training : Staff files are maintained at the facility. All staff have current CPR first aid training. Facility has documentation on file that verify CPR for all staff. Residents Records-Information: Resident files are maintained at the facility and have the following documents in their files - Admission Agreements, Identification & Emergency Information, pre-admission assessment and other required documentation. Food Service: There are sufficient food supplies of 2-day perishable and a week (7 days) of non-perishable items. The food is properly stored in the refrigerator to avoid cross contamination. Incidental Medical & Dental: The medications are centrally stored and in their original containers. During the visit today, LPA reviewed 5 client’s medication and medication is administered following physician’s orders. PRN letters were not on file. Disaster Preparedness: The facility has an Emergency Disaster Plan with contact numbers and at least 2 relocation sites. Last emergency drill 4/27/2023 Residents with Special Health Needs: Facility accepts and retains residents with special health needs. During the visit today, LPA did observed deficiency at time of visit. See 809D. Technical advisories were provided. An exit interview was held. A copy of this report, technical advisory notes, and appeal rights were given to Licensee Richard Villaverde