Routine inspection·August 15, 2024

Licensing Program Analysts (LPAs), Stephanie Martinez and Armando Perez, conducted a required annual inspection at the facility. The LPAs were allowed entrance into the facility and met with Co-Administrator, Vijethaa Balaji . The LPA informed the Co-Administrator of the purpose for the visit. The inspection included the following: Physical Plant: The facility consists of four (4) resident bedrooms, one (1) staff bedroom, three (3) bathrooms, a kitchen and dinning area, a living area, a laundry room, garage, and a patio and yard with sufficient seating and space for activities. There are no bodies of water located on the property. According to the Co-Administrator, 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 debris and other trash. There are grab bars for each toilet, bathtub and shower used by residents. Resident showers have non-skid mats or strips present. The smoke and carbon monoxide detectors were tested and observed to be in operating condition. The home was kept clean and free of any odors. Food Service: A variety of food was available. Sufficient dinning supplies were available for residents in care. Record Review: Staff responsible for direct care and supervision have current first aid and CPR training. Staff Two (S2) did not have current Dementia training, postural support training or hospice training on file; which are required annual training. S2 had some training related to restricted health Conditions; however, the training was incomplete. No staff file was available for Staff Three (S3) or Staff Five (S5). According to the Co-Administrator, no file was available for S3 because the staff just started working at the facility. According to S3, they have been working at the facility for two days. According to the Co-Administrator, S5 does not have a personnel file due to the individual being a volunteer. She reported S5 has been working for the facility for approximately two weeks. LPAs observed S5 to be present and working at the facility during the visit. S5, however, did not have a fingerprint clearance. According to the Co-Administrator, S5 works at the facility 40 hours per week and does activities with the residents in care. The facility was not operating beyond the conditions specified on the license. The facility currently has an approved Hospice Waiver for two (2) residents and there are currently no residents in care receiving hospice services. There is a disaster and mass casualty plan in place. Medication Review: The LPA inspected resident medications. Medications were observed to be well organized, labeled and inaccessible to unauthorized individuals. An exit interview was conducted with the Co-Administrator, in which this report was reviewed and a copy was provided, along with the LIC 811, LIC 9098, LIC 421BG, and instructions on appeal rights