Routine inspection·October 30, 2024

Licensing Program Analyst (LPA), Stephanie Martinez, conducted a required annual inspection to the facility. The LPA was allowed entrance into the facility and met with Administrator, Musarrate Khan. The LPA informed the Administrator of the purpose for the visit. The inspection included the following: Physical Plant: The facility consists of five (5) resident bedrooms, two and one half (2 1/2) bathrooms, one (1) staff room, a kitchen and dinning areas, a living room area, a garage, and a yard and patio with sufficient seating and space for activities. There are no bodies of water located on the property. According to Administrator Khan, 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. Resident showers have non-skid mats or strips present. The carbon monoxide and smoke detectors were tested and were observed to be in operating condition. The home was kept clean, organized and free of any odors. Food Service: There is a minimum of two (2) days supply of perishable foods and one (1) week's supply of non-perishable foods available. Sufficient dinning supplies were available for residents in care. A variety of food was observed to be 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. Staff responsible for direct care and supervision have current first aid and CPR training. Dementia care and medication training was observed to be complete. Resident files had admission agreements and medical assessments available for review. One of six residents did not have an updated medical assessment on file. Resident Six (R6), whose health condition requires an annual medical assessment last had an evaluation on 10/04/2019. According to Administrator Khan, no previous medical assessments were requested for the resident until October 2024. A citation will be issued. In addition, one of six residents did not have an updated written record of care. The last written record of care for Resident Six (R6) was dated 06/08/2021. According to Administrator Khan, no updated record of care was completed for the resident. A citation will be issued. The facility was not operating beyond the conditions specified on the license. The facility currently has an approved Hospice Waiver for two residents and there is currently one residents in care receiving hospice services. The LPA observed current liability insurance on file. Medication Review: The LPA inspected resident medications. Medications were observed to be organized, appropriately labeled and inaccessible to unauthorized individuals. Technical Assistance and Technical Violations were issued to Administrator Khan for other, non-immediate, violations observed during the LPA's visit. Administrator Khan agreed to provide the LPA with a copy of the current liability insurance, proof of control of property, a staff schedule, and a resident roster to update the facility file. An exit interview was conducted with the Administrator, in which this report was reviewed and a copy was provided, along with the LIC 811, LIC 9098, and instructions on appeal rights.