Routine inspection·August 2, 2022

Licensing Program Analyst (LPA) conducted an unannounced visit for the purpose of conducting a Required 1 Year inspection. LPA was greeted and granted entry by Care staff Jamil Razon and reason for visit was explained. LPA Frank toured the facility. There are 5 residents residing in the facility and no active COVID-19 cases. LPA observed 5 residents on site appeared clean and well taken care and 1 resident is receiving hospices care. LPA observed required department postings in the facility as well as hand washing signs in the restrooms. All restrooms observed had ample soap/ sanitizer and appeared clean. Resident bedrooms appeared clean and sanitary. LPA observed 2 day supply of perishables and 7 day supply of non-perishable food is available for the number of residents present. Hygiene supplies and supply of linen were observed in quantities for the number of residents in care. LPA observed locked areas for toxins and hazardous items. Medication were observed locked in cabinet. LPA observed Facility’s physical plant, hallways appears to be clean and free of debris, free of odor. Sufficient lighting observed throughout the facility. No bodies of water, weapons or ammunition on premises. In addition, LPA Frank tested the hot water temperature, which measured 107.1 degrees F in resident bathroom. Resident areas were noted to be a comfortable temperature. Smoke detectors and carbon monoxide detector were tested and are operational. Fire extinguishers were fully charged. Fire drill was conducted on 5/18/22. Facility stove, oven, microwave, refrigerator, washer and dryer are clean and operational. LPA observe the facility to be clean and in good repair. LPA Frank reviewed Emergency Disaster Plan (LIC610E); LIC 9020A Client Roster; LIC 808) Mitigation Plan and Current Liability Insurance; Designation of Administrative Responsibility (LIC308) and Personnel Report (LIC500). Based on the observations made during today’s visit, no deficiencies are being cited in area inspected. This report was discussed with the facility representative and a copy was provided .