Routine inspection·July 22, 2024

Licensing Program Analyst (LPA) Dwayne Mason Jr. arrived at the facility unannounced for the purpose of conducting a required annual inspection. LPA was greeted and granted entry into facility by Dolores Benedicto, Licensee. The facility is a one-story home with five resident bedrooms, one staff bedroom, one resident bathroom, one staff bathroom, kitchen, dining room, living room, family room, backyard and attached 2-car garage. A section of the home is blocked off from resident access. This part of the home houses family of the Licensee. All resident rooms had required elements, including bed, chair, closet space and ample lighting. Facility has extra linens for residents in the hallway closet. Restrooms are stocked with soap and paper towels. LPA measured water in resident bathroom to be 110.4 degrees Fahrenheit. LPA noted Fire Extinguishers were last serviced on 06/17/2024 according to the service tag on them. LPA observed the smoke/carbon monoxide detectors to be operational. Facility keeps emergency water and emergency disaster supplies in the garage. LPA observed hazardous items such as knives, chemicals and cleaners to be locked up in cabinets. Knives are locked up separate from toxic chemicals. Medication for each resident is kept locked in a closet in the hallway. The backyard has a shaded sitting/lounging area. Exit gate is unlocked. LPA observed exit gates to be unobstructed. LPA observed a sample menu and activity calendar in the facility. LPA reviewed two of the four resident files and two staff files. LPA also reviewed medication for two out of four residents. LPA interviewed one resident and one staff. Based on record review, LPA determined facility does not have a documented disaster drill log. A deficiency is being issued. Based on record review, LPA advised facility to create a dementia care plan, hospice care plan and bedridden care plan to maintain in the facility plan of operations. LPA issued three Technical Violations (TVs). One deficiency and three TVs are being issued based on today's inspection. An exit interview was conducted and a copy of this report and appeal rights were provided to the facility.