Routine inspection·December 18, 2024

On 12/18/24 Licensing Program Analysts (LPAs) Cheyenne Ratajczak and Graham Gunby arrived at the facility unannounced to conduct a Required 1 year annual inspection utilizing the care tool. LPAs met with Administrator, Adi Lina Tuiloma and explained the purpose of the visit. LPAs and Administrator conducted a tour of the interior and exterior of the facility. Areas toured include but not limited to: resident bedrooms, bathrooms, laundry room, kitchen and the common areas. While on tour LPAs observed two (2) residents residing in a room that is cleared for only one (1) non- ambulatory resident. LPA conducted a file review of four (4) resident files. Residents files contain signed admission agreements, physician reports, Identification sheets, releases, preplacement appraisals, and resident rights. LPA also conducted a file review of two (2) staff files. Staff have training in dementia, first aid and CPR, and other various areas of care provision. CARE inspection tool completed and deficiencies was observed. Please see LIC 809-D. Today's visit, civil penalties assessed. LPA requested a copy of facility's liability insurance, LIC 500 and LIC 308 by 12/20/24. Exit interview conducted and a copy of the report and appeal rights was left at the facility.