Routine inspection·February 28, 2022

Licensing Program Analyst (LPA) Albert Marin made an unannounced required annual inspection in this facility. LPA met with Staff Flavia Borduz and stated the purpose of this visit. The facility is a single level structure and licensed for six non-ambulatory of which one may be bedridden; and hospice waiver for two. for this visit, there was one resident under hospice care. About 10;50 AM, LPA Marin toured the interior and interior portions of the facility. LPA observed one resident in care and one staff member on the floor. There were three private resident's rooms. Rooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke carbon monoxide, and auditory exit alarms were tested to be operational. Bathrooms were observed to be in good repair; and provided with handrails and nonskid-floor mat. Hot water was measured at 120 degrees Fahrenheit. Facility met the minimum two-day perishable and seven-day non-perishable food stock requirements. Medications, cleaning supplies and sharp items were inaccessible to residents in care. Fire extinguisher was mounted and charged. For the exterior portion, facility had outside furniture in good repair. Side exit doors were self closing and self latching. LPA Marin reviewed the COVID 19 mitigation plan of the facility. For this visit,no citation has been issued. LPA Marin conducted an exit interview with Ms. Borduz and copy of this report was left in the facility.