Routine inspection·August 14, 2024

Licensing Program Analyst (LPA), Stephanie Martinez, conducted a required annual inspection at the facility. The LPA was allowed entrance into the facility and met with staff, Jac Anda. The Administrator, Lidia Popa, was notified of the purpose for the visit via telephone. The inspection included the following: Physical Plant: The facility consists of four (4) resident bedrooms, four (4) staff/private rooms, three (3) bathrooms, storage areas, a kitchen and dinning areas, one (1) living space, two laundry rooms, and a patio and yard with sufficient seating and space for activities. There are no bodies of water located on the property. According to staff Anda, no weapons are stored in the home. The facility is being maintained at a comfortable temperature. All outdoor and indoor passageways are kept free of obstruction and are free of debris and other trash. There are grab bars for each toilet, bathtub and shower used by residents. The smoke and carbon monoxide devices were tested by staff Anda and were observed to be in operating condition. The home was kept clean and organized. LPA was notified by staff there is no facility telephone at this time, a fter the LPA was unable to reach the facility at the number listed, on 08/14/2024. On 08/11/2023 the facility was also unable to be contacted by LPA, Sara Martinez, during a visit. A citation will be issued. Food Service: There is a minimum of 2 days supply of perishable foods and 1 week's supply of non-perishable foods available. Sufficient dinning supplies were available for residents in care. A variety of food was available and stored in a safe and healthful manner. Record Review: All staff were observed to have appropriate fingerprint clearances. LPA did not observe any excluded individuals on the premises at time of visit. Staff responsible for direct care and supervision have current first aid and CPR training. Completed training included dementia related training, hospice related training, postural support related training, and emergency training. The facility currently has an approved Hospice Waiver for two (2) residents and there is currently one resident in care receiving hospice services. Proof of emergency drills were observed on file. All records were observed to be well organized. LPA observed during a review of resident records there is a bedridden resident in care, Resident Two (R2). The Physician's Report for Residential Care Facilities for the Elderly (RCFE) indicated the resident is bedridden. According to Administrator Popa, R2 is not bedridden; however, one staff interview reported R2 is unable to rotate on their own. A citation will be issued and civil penalty will be issued. A review of the hospice file for Resident Two (R2) was completed. No hospice care plan was observed on file. A citation will be issued. The LPA reviewed the facility's liability insurance. The liability insurance on file indicated the general aggregate is $2,000,000.00 rather than a total annual aggregate of $3,000,000.00. A citation will be issued. Medication Review: The LPA inspected resident medications. Medications were observed to be well organized, appropriately labeled and inaccessible to unauthorized individuals. An exit interview was conducted with Administrator Popa, in which this report was discussed and a copy was provided, along with the LIC 811, LIC 9098, and instructions on appeal rights. This report was also reviewed with staff Anda.