Routine inspection·February 21, 2025

02/21/2025, Licensing Program Analyst (LPA) Loera conducted an unannounced Annual Required – 1 yr. inspection visit for this facility. Facility has an emergency disaster plan as required. Facility has an infection control plan as required. There are currently 3 residents in care. Facility approved/cleared for 4 non-ambulatory and hospice waiver for 2. At approximately 9:30am, LPA and Administrator toured the building and grounds. The facility was found to be at a comfortable temperature. LPA observed a 2 day supply of perishable and 7 day supply of non-perishable food. Refrigerated food was found to be stored and secured. All rooms were equipped with lighting, nightstand, and chest of drawers. All rooms were in good repair. Extra hygiene products and linens were available in hallway closet. Water temperature in sinks accessible to residents in care were measured at 115.3 degrees F which is within the range of 105 to 120 degrees F. Fire extinguishers were last inspected 02/2025. Smoke/Carbon Monoxide detectors located throughout the facility are operational. Toxins, sharps and other items that could pose threat if available to residents were located in the garage and in the kitchen and found to be secured. LPA observed living room and dining area to be cluttered with medical equipment such as wheel chairs (see complaint number 21-AS-20250214163627 for deficien cy ) . Medications were found to be centrally stored. LPA conducted spot medication count and found all prescription medication to be properly recorded on the Centrally Stored Medication Record. LPA conducted a review of 3 resident records. 1 out of 3 residents were missing their needs and service plan (Technical Violation) . LPA conducted review of 2 staff records/training. Upon a review of staff records, LPA found all staff to have required annual and initial training. 2 our of 2 staff have expired 1st Aid & CPR certification (Technical Violation) . No deficiencies cited during today's inspection. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 03/21/2025: LIC500- Personnel Report LIC308- Designation of Responsibility Updated Liability Insurance LIC610E- Emergency Disaster Drill (review, update if needed) Exit interview conducted with Administrator and a copy of this report was provided .