Routine inspection·November 14, 2024

11/14/2024, 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 6 residents in care. Facility approved/cleared for 10 non-ambulatory and hospice waiver for 2. At approximately 1:00pm, LPA and Licensee 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 in a safe manner. Extra food is supplied in a second refrigerator. Medications were found to be centrally stored. All resident rooms were equipped with lighting, night stand, and chest of drawers. All rooms were in good repair. Extra hygiene products and linens are available to residents in care. Water temperature in sinks accessible to residents in care were measured at 115.1 degrees F which is within the range of 105 to 120 degrees F. Fire extinguishers were last inspected 11, 2024. LPA noticed the wall next to the office to be cracked/damaged (Deficiency Cited). Damage is approximately 27 inches in height and 17 inches in width. Licensee states they hit the wall with their scooter by accident and the maintenance guy is suppose to fix it in a few weeks when they return from vacation. Smoke/Carbon Monoxide detectors located throughout the facility were tested and operational. Toxins are stored in the laundry room which is kept locked. Sharps are located in a kitchen drawer and were found to be secured. 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. All records had the required documentation. Continued on LIC809C LPA conducted review of 3 staff records/training. Upon a review of staff records, LPA found all staff to have required annual and initial training as well as current 1st Aid & CPR certification on file. See LIC809-D for Deficiency. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report LIC309- Administrative Organization Liability Insurance Infection Control Plan (review, update if any changes) Emergency Disaster Plan (review, update if any changes) Exit interview conducted with Administrator and a copy of this report was provided .