Routine inspection·April 25, 2022

Licensing Program Analyst(s)(LPA) Mary Flores conducted an unannounced annual visit at the facility with focus on infection control, food, and medication review. LPA Flores met with Jennifer Leon administrator and explained the reason for the visit. The facility is licensed to served 6 non-ambulatory residents over the age of 60; of which 1 may be bedridden in room #4. Hospice waiver for 6 residents. The facility is a single story house located in a residential area which consist of a 2 living rooms, attached garage/laundry area/storage, kitchen, dining area, 5 resident bedrooms, 2 staff bedrooms, 2 bathrooms and a sun room/office, a backyard. No large bodies of water were observed. LPA Flores conducted a tour of the facility and observed the following: Living room has a covered fireplace, screening is conducting upon entry and it's located by the living room, medication closet was locked and located next to exit door. Kitchen was observed with sharps, and cleaning supplies locked. Sufficient food was observed for at least 2 days worth of perishables and 7 days of non perishables. All bedrooms have sufficient lighting, furniture and bedding supplies. Bathrooms have skid mats and grab bars, cleaning supplies were observed under each sink and locked, water was tested as follow; in bathroom #1 water tested at 110.5 degrees F., and bathroom #2 water tested at 114.2 degrees F., which is within the required 105 - 120 degrees F. Auditory devices were observed and in working condition in each exit door. Smoke detectors were tested and in working condition. Fire extinguishers were observed in kitchen and garage and are up to date. LPA Flores reviewed 6 residents medications and files and 3 staff files. Facility is following COVID 19 recommendations. A technical advisory has been given for N95 Fit testing. No deficiencies were given during this visit under Title 22 Regulations. Exit interview was conducted with Jennifer Leon administrator and a copy of this report and advisory note were provided.