Routine inspection·January 9, 2024

On 01/09/24, Licensing Program Analyst (LPA) Cheyenne Ratajczak arrived unannounced at the facility to conduct a Required 1- year annual inspection utilizing the care tool. LPA met with Administrator, Filomena Taylor and explained the purpose of the visit. LPA and Administrator conducted a tour of the interior and exterior of the facility. Areas toured included but not limited to: three (3)residents room, two (2) bathroom, kitchen, backyard, storage area, and the common areas. LPA observed one resident in the common area watching television and one resident in their room. LPA observed the facility to have 2+ days of perishable and 7+ days of nonperishable foods. LPA observed toxins and knives to be locked and inaccessible to residents in care. LPA also observed centrally stored medications are kept locked and inaccessible to residents. Hot water temperature was measured at 106 degrees Fahrenheit in kitchen sink, which is within the required range of 105 to 120 degrees. Smoke detectors are current and in compliance with fire safety including carbon monoxide detector. Fire extinguisher and first aid kit are maintained and ready for emergency use. LPA conducted a file review of personnel and residents records. LPA observed one staff file to be incomplete with the required documents. LPA provided facility with a copy of LIC311F, which states what is needed for the resident, personnel, administrative and dementia care records LPA completed the full care tool and deficiencies was observed. Please see LIC 809-D. Exit interview conducted and a copy of the report and appeal rights was provided.