Routine inspection·February 7, 2025

Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted an unannounced Required (1) year inspection at this facility. LPA met with caregiver and gained entry. Later, Administrator arrived and explained the reason for the visit. A tour of the physical plant was conducted at 11:00a.m. and the following were noted: The facility has one main entrance being used. Required posting are observed to be complete and current and displayed properly. The facility has an approved mitigation and infection control plan on file. There are hand sanitizer and mask all over the facility. Signs to wear a mask and other COVID 19 prevention protocol signs were posted on the walls. Hand washing, coughing etiquette, physical distancing and other necessary signs were posted in the bathroom. All trash cans were observed to be with cover. The facility is licensed for a Residential Care Facility for the Elderly, capacity of five (05) non-ambulatory residents and one (01) bedridden resident. The facility is a single story, three (03)bedroom home all rooms are for residents. Two (02) rooms are shared and one (01) is private. There are a total of five (05) smoke and carbon monoxide combination detectors at the facility. Each bedroom has a detector, one (01) in the hallway, one (01) in the living room, were tested and functions properly. Fire extinguishers was in the kitchen and observed to be full with date of purchased 12/10/2024. House Evacuation/Fire drill was last conducted on 10/06/2024. Physical Environment was checked for cleanliness and condition. Walls, windows, ceilings, floors and floor coverings, and doors were observed to be in good repair. Passageways and doors are not blocked, and handrails are securely fastened. There is no body of water and garage at the facility. Living and Dining room furniture were checked. The living room is neat and clean along with the dining Cont. LIC 809C room. Furniture were observed to be in good repair and excellent condition. The facility maintains a comfortable temperature at 74°Fahrenheit. Food Service / Kitchen area was sufficiently stocked with two (02) days perishable and seven (07) days non-perishable food. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. The kitchen appeared clean and the appliances and fixtures functional. Knives and sharps are observed to be kept in the kitchen cabinet locked and inaccessible to residents. Under the sink cabinet there are cleaning agents and observed to be locked. Resident rooms are adequately furnished with appropriate furniture and lighting system. Hallway/passageway is lit. Residents have sufficient amounts of personal hygiene product which is provided by the licensee. Bathrooms were checked for cleanliness and proper operation. LPA observed the appropriate grab bars for each toilet and shower. The hot water temperature measured at a range of 110.6 to 111.9°Fahrenheit. Towels and washcloths are not shared. There is enough clean linen available in stock in the rooms. Medications : LPA observed medication in the kitchen locked cabinet and inaccessible to residents. First aid kit is observed to be with complete tools and supplies. Laundry room is located at the side of the facility with no access from inside. Laundry room was observed to be locked and inaccessible to residents. Laundry detergent, cleaning agents and other toxins are observed to be locked and secured in the locked laundry room. Staff records were reviewed. Staff present had criminal record clearances and associated to this facility. Staff records appear to be complete and current. Resident records were also reviewed and appeared to be complete and current. There is no health and safety issue observed during this visit. Exit interview conducted. A copy of this report issued.