Routine inspection·July 2, 2025

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by facility caregiving staff after introducing himself and stating the purpose of the visit. Administrator Jean-Pierre Delagneau was notified of the visit via telephone and arrived later to assist. There are currently four residents in care, two of which are receiving hospice care at this time. LPA observed residents relaxing in their respective bedrooms or in the facility's common living areas. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with an attached garage, with four private bedrooms, one shared bedroom and two shared bathrooms. Bedrooms appear clean and sanitary. There are three residents requiring the use of half rails for postural supports at the time of the visit. Hospice plans of care reviewed for the relevant residents. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary and are equipped with grab bars and slip mats. Hot water temperature measured at 109F and 110F in two separate bathrooms equipped with faucets used for personal grooming. LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items, cleaning supplies and the medication central storage are verified to be secured. Medication belonging to a staff member is however observed to have been left on the dresser in one of the bedrooms. Type B citation issued. CONTINUED ON FORM LIC809-C CONTINUED FROM LIC809 Fire extinguisher present is charged with up-to-date maintenance tag. Smoke detectors were found to be operational. Carbon monoxide detector found to have an inoperant battery that was replaced during the visit. Type A citation issued and cleared. The garage is secured and used for the storage of supplies and food. Laundry room and cleaning supplies are secured. Emergency food and water supplies verified to be present. LPA and facility staff toured the outside of the facility. LPA observed a shaded outdoor seating area with furniture for resident use. The identified route of egress is free of clutter and obstructions. There are no bodies of water on the premises. Gardening equipment observed not to be secured. Type B citation issued. Egress alarms are in use on exit doors, however facility does not utilize locked perimeters or delayed egress. LPA reviewed four resident records which included all necessary components. LPA reviewed resident medication records and prescription orders for all residents with no discrepancies observed. One resident is observed to have been assessed as bedridden upon admission but is currently able to reposition and attends meals and activities in the common living areas. Type B citation issued as the change in condition has not been documented at this time. Consultation provided on updated requirements for medical assessments and copy of the updated physician report LIC602a provided. Resident interviews were conducted or attempted during the visit along with staff interviews. LPA reviewed staff records for three staff members present during the visit. CPR training, initial and annual training reviewed for 2024 and 2025. Disaster drills are conducted quarterly and documented. Staff members are verified to be background cleared and associated to the licensed location. Administrator certificate is pending, consultation provided. The governing body appears to be inactive per Secretary of State records, consultation provided. Based on the observation conducted during the present visit, one type A deficiency and 5 type B deficiencies are being cited. An exit interview was conducted and a copy of this report was provided.