Post-licensing visit·March 14, 2023

Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a post-licensing inspection utilizing the post-licensing inspection tool. LPA met with Assistant Administrator (Asst Admin), Noel Estillore, and explained the purpose of the visit. Today's census is 6 with (3) resident on hospice services. Facility is licensed for capacity of 6 and hospice waiver of 6. LPA and Asst Admin conducted a tour together to ensure the health and safety of residents in care. In areas toured included but not limited to the common areas, kitchen, dining room, staff restroom, resident private bedrooms and bathrooms. During the tour, LPA observed (2) caregivers present wearing mask. LPA observed (2) residents in the common area watching television, (3) residents alone in their private rooms and (1) resident to be in their private room with a nurse. LPA observed the kitchen to have sharps and medication to be locked and secured. LPA observed the facility to have 2+ days of perishable and 7+ days of nonperishable foods. LPA observed fire extinguisher to be last serviced on 10/14/2022. LPA and Asst Admin completed the post-licensing inspection tool and facility was found to be in compliance. LPA conducted a file review of (1) out of (6) residents files and (2) personnel files. As a result of today's inspection, no deficiencies cited. Exit interview conducted and a copy of the report was left at the facility.