Routine inspection·August 28, 2023

On 8/28/2023, Licensing Program Analyst (LPA) Janette Romero arrived unannounced at the facility to conduct an annual required visit. LPA was greeted and granted entry by Caregiver Marites Barcelo who was informed of the purpose of visit. During the visit, four (4) residents and two (2) staff present. The facility is approved to care for six (6) non-ambulatory residents and has a hospice waiver for three (3). The facility is made up of four (4) resident bedrooms, two (2) resident bathrooms, a kitchen, dining room, living/family area, laundry room and garage. During the visit, LPA observed the following: Kitchen: LPA observed kitchen to be clean. Food is stored in a safe and healthful manner. Sharps are secured in a locked kitchen drawer. The facility has a 7-day supply of non-perishable food items, but did not have a 2-day supply of perishable food items. Deficiency cited. Dining and Living room: LPA toured the dining and living/family room area. LPA observed areas to be clean and furniture in good condition. LPA observed residents watching television in the living room and sleeping in their rooms. Fire extinguisher is charged and mounted in the dining room. Hallway : LPA observed hallway to be clean with no pathway obstruction. Carbon monoxide and smoke detector were tested and functioning properly. Continued on LIC809-C.. Centrally Stored Medications: LPA observed a first aid kit with required components. Medications were secured in a kitchen cabinet. LPA reviewed physical medications for two residents along with the digital Medication Administration Record (MAR) and did not observe any discrepancies. Hallway : LPA observed hallway to be clean with no pathway obstruction. Carbon monoxide and smoke detector were tested and functioning properly. Bedrooms : Resident bedrooms were each furnished with a bed, chair, closet, clothing storage and lighting. Bathrooms: Bathrooms have a working toilet, wash basin, and were equipped with a grab bar in the shower. The hot water temperature measured at 108-degrees Fahrenheit. The facility has clean towels, blankets, and linen, available in different colors for the residents in care. Laundry/Garage : LPA observed laundry room and garage to be clean. Washing machine and dryer are in good repair. Cleaning solutions and chemicals are secured in a locked cabinet in the laundry room. Emergency food supplies, water and incontinent supplies are stored in the garage. Records: Staff present have a criminal record clearance on file and are associated to the facility. Staff present have a current CPR/First Aid certificate. Yard/Outside Area: Covered patio seating is available for residents. A brick wall secured the entire backyard. All outdoor pathways were free of obstructions. No bodies of water were observed. There were no firearms or ammunition observed at the facility, and LPA was informed the facility will not store firearms or ammunition on the premises. During today's visit, LPA observed one deficiency faulting the facility. An exit interview was conducted, and a copy of this report was reviewed and provided to Caregiver Barcelo along with an LIC809-D and Appeals Rights.