Routine inspection·November 28, 2023

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual. LPA met with caregiver, Icelyn Allen, and explained purpose of inspection. Alex Molitvenik, Administrator, arrived at approximately 2:35 pm. The facility is licensed for (6) non-ambulatory residents and has an approved hospice waiver for (4) residents. LPA observed all residents to be resting in their rooms at the start of the inspection. LPA and the Administrator toured the interior and exterior of the facility including the common areas, (5) resident bedrooms, (3) resident bathrooms, kitchen, office, laundry area. LPA observed the facility to be clean, in good repair and odor-free, and the bathrooms to have the necessary grab bars, non-skid flooring, paper towels. Administrator to post 20-second hand-washing poster by each sink. LPA observed sufficient 2+day perishable supply of food, including fresh produce, and 7+day non-perishable supply of food. Sharps, toxins and medications were locked in the kitchen. LPA observed sufficient linens/blankets/incontinent/PPE supplies, PPE, and a complete First Aid kit. The inside temperature was 75*F. Hot water temperature measured 105*F in the kitchen. The fire extinguisher was last serviced 11/6/23. Fire/smoke monoxide alarms are in working order. There are (2) unlocked exits in the backyard and plenty of outdoor/indoor space for activities. Required postings are posted. LPA reviewed (3) of (4) resident files- they were found to be organized and contain current documentation. Medications were reviewed for (2) residents and no discrepancies were noted. Documentation is maintained and meds are pre-poured only for the day. (1) of (2) staff files were reviewed. Staff has completed all initial training as required, and First Aid/CPR is current for both staff. Administrator certificate #6024306740- exp 1/18/25. Administrator to provide current copy of LIC 308, LIC500, liability insurance and LIC9282 (Infection Control Plan) to the Department by 12/8/23. There are no deficiencies cited. Exit interview. Copy of report provided to Administrator.