Post-licensing visit·July 20, 2022

Licensing Program Analyst (LPA) Erik Gonzalez Campos arrived unannounced on 07/20/2022 to conduct a Post Licensing Inspection . Upon arrival LPA filled out a COVID screening form. Staff took LPA's temperature. Licensee/administrator was not available during the inspection but was notified over the phone. Licensee/administrator agreed to have LPA perform inspection with staff, Luisita Makalintal. LPA toured building and grounds with staff. Facility was clean and in good repair. All exits and doorways were unobstructed. During the pre-licensing inspection it was noted that three out of five resident bedrooms did not have lamps as required per regulation. LPA observed lamps in all resident bedrooms during inspection on 07/20/2022. Long term care ombudsman poster was displayed prominently in the front entrance. LPA measured water temperature in bathroom shower faucet at 120.3 degrees F which is above the maximum allowable amount of 120 degrees F. LPA provided technical assistance and requested licensee submit a 7 day temperature log documenting temperature for shower faucet after adjustments. Water temperature in the kitchen sink was measured at 123.6 degrees F, per staff this faucet is not accessible to residents. Medications were locked and inaccessible to residents in care. LPA requested licensee/administrator submit updated copies of the following by 08/01/2022: LIC 9020 Admission Agreement Copies of staff First Aid/CPR Training Medication Administration Record for 1 Week No deficiencies observed during the inspection. Exit interview conducted with staff, and a copy of the report printed for the facility.