Routine inspection·July 29, 2024

Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose of conducting the Required 1-Year annual inspection using the CARE Tool. LPA was greeted and granted entry by Caregiver Nestor Angeles and Administrator Elizabeth Joaquin was advised of the visit by telephone approximately 9:55am. During today's visit, LPA observed two residents in care and one live-in caregiver on duty. LPA observed the facility to be clean and sanitary. There are six resident bedrooms and three resident bathrooms. There is an additional private bedroom for the staff. All common areas were inspected including the attached two car garage and laundry room. The residents' bedrooms were appropriately furnished. Beds and bedding supplies were in good condition, adequate lighting was provided, sufficient storage space for each residents' personal belongings were observed. Bathrooms were found to be in compliance, clean, and operational. The water temperature measured at 117.5, 117.6, and 119.1 degrees Fahrenheit. LPA observed the indoor temperature was within a comfortable range. Toxins, disinfectants, sharps, and medications were secured and inaccessible. LPA observed sufficient two-day supply of perishables and seven-day supply of non-perishable food available. LPA toured the exterior portion of the facility. LPA observed the outdoor passageway free of obstructions. The exit gate was in good repair. LPA observed sufficient seating and shading. Facility maintains a fire extinguisher which was mounted, charged, and serviced on April 10, 2024. The auditory devices and smoke/carbon monoxide detectors were tested and operational. Emergency disaster supplies including food/water were present. Emergency evacuation drills were not conducted on a quarterly basis with the last drill on June 20, 2021. The first aid kit contains all necessary elements. LPA observed the required 'See Something, Say Something' (PUB475) poster in an incorrect size posted on the bulletin board in the hallway in the size of 8.5"x11." LPA verified that Administrator Elizabeth Joaquin has completed all course work on May 24, 2024. LPA conducted an audit of two residents' files and two personnel files. Facility did not obtain a medical assessment and Tuberculosis test for Resident #1 (R1). Residents/staff interviews were conducted and medications were audited. No discrepancies noted. Based on the observations made during today's visit, deficiencies are being cited. Advisory Notes are being issued. An exit interview was conducted with Administrator Elizabeth Joaquin by telephone approximately 12:38pm and Caregiver Nestor Angeles signed the report on behalf of the administrator. A copy of this report and the appeal rights were provided at the end of the visit.