Routine inspection·May 13, 2025

On May 13, 2025, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility for the purpose of conducting the required annual inspection. LPA was greeted and granted entry into the facility by care giving staff after explaining the purpose for the visit. Administrator (AD) Agoston Vass was notified via telephone but could not assist with today's inspection. LPA observed that Agoston Vass has a valid Administrator certificate which expires on July 2, 2025. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents and has a hospice waiver for five. The facility is a two story home with three resident bedrooms, one of which is shared, one resident bathroom, a living room, a dining room, a kitchen, and an attached two car garage. LPA, accompanied by a caregiver conducted a tour of the interior portion of the facility. On today's visit, LPA observed three residents in care and one staff present. LPA observed residents relaxing in their respective bedrooms and in common areas. LPA observed the See Something, Say Something poster (PUB 475) mounted on the wall by the entryway of the facility. All resident bedrooms and the resident bathroom is located on the first floor of the facility. LPA inspected the three resident bedrooms and they were observed to be free of hazards. LPA observed residents bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed resident beds had clean linens and blankets. LPA observed additional linens to be stored in a hallway cabinet. LPA inspected the one resident bathroom. Resident bathroom was clean. Resident bathrooms were equipped with grab bars and non-skid floors. Faucets and toilets were operational. Hot water temperature measured 117.3 degrees Fahrenheit. LPA observed the second story of the facility to be for staff use only and off limits to residents in care. CONTINUED ON 809-C LPA observed the kitchen has a two day perishable and a seven day nonperishable food supply on hand. LPA observed kitchen appliances to be clean and operational. The five burner gas stove lights unassisted. LPA observed kitchen knives and sharps to be stored in a locked kitchen cabinet. LPA observed chemicals and toxins to be stored in a locked kitchen cabinet under the sink. LPA observed a fire extinguisher to be mounted on the wall by the dining room. The fire extinguishers were observed to be charged and up to date on service. LPA tested the wired smoke detectors/carbon monoxide detectors which tested operational. LPA observed the facility conducted their last emergency disaster drill on February 1, 2025. LPA observed the centrally stored medication to be kept in a locked cabinet in the resident hallway. LPA observed the facility has a First Aid Kit stored in the resident hallway and it had all the required components. LPA observed chemicals and toxins to be stored in a locked cabinet in the resident hallway. LPA observed the facility has a three day emergency food and water stored in the pantry. LPA observed the door leading to the attached two car garage to be kept locked and inaccessible to residents in care. LPA observed the garage to be used for storage. LPA, accompanied by the AD, conducted a tour of the exterior portion of the facility. The exterior portion was observed to be free of hazards and obstructions. LPA observed the perimeter gate on the east side of the facility to be self latching and can be opened in an evacuation. There are no bodies of water on the premises. LPA reviewed all three resident files. LPA observed that per Resident #2 (R2) medical assessment, they have an ambulatory status of bedridden. However, the facility is not approved to retain a bedridden resident. LPA reviewed residents' medication and medication records. LPA reviewed two staff files. All staff are background cleared and associated to the facility. Based on the observations made during today's visit, a deficiency is being cited on the attached 809-D and civil penalties are being assessed. An exit interview was conducted with Caregiver Melinda Vass. A copy of the report and Appeal Rights were provided.