Routine inspection·August 21, 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 Administrator, Cristina Dato. The LPA informed the Administrator of the purpose for the visit. The inspection included the following: Physical Plant: The facility consists of three (3) resident bedrooms, one (1) staff room, three (3) bathrooms, a kitchen and dinning area, a living room, a laundry room and 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 Administrator Dato, there are no weapons 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. Resident showers have non-skid mats present. The carbon monoxide and smoke detectors were tested and observed to be in operating condition. The home was kept exceptionally clean and organized. 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. 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. There is at least one staff member on the premises with current First Aid and CPR training. Resident records had required documentation; such as admission agreements, medical assessments, and pre-placement appraisals. The medical assessment (physician's report); however, for Resident One (R1) was missing information on the resident's TB test results. Resident Two's (R2's) physician's report was not completely filled out; the report was missing information on the resident's ambulatory status. Resident Four's (R4's) and Resident Five's (R5's) physician's report was missing the TB test information. A citation will be issued. A disaster and mass casualty plan was observed on file. Proof of emergency drills was observed on file. All records were observed to be well organized and safely secured. The inspection found the facility was operating beyond the conditions specified on the license. The facility currently has an approved Hospice Waiver for two (2) residents; however, there are currently four (4) residents in care receiving hospice services. 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 Dato in which this report was reviewed and a copy was provided, along with the LIC 811, LIC 9098, and instructions on appeal rights.