Routine inspection·March 13, 2024

On 3/13/24, Licensing Program Analyst (LPA) Michelle Echeverria arrived unannounced to conduct the required annual visit to the facility. LPA met with staff, Ajanae Clark and introduced self and stated purpose of the visit. LPA was informed that there are currently 6 residents in which 5 are in the facility and 1 hospitalized. LPA phone called the administrator, Angela Breedlove and informed about the purpose of the visit. The facility has 6 resident bedrooms with their own private bathroom, 1 staff bathroom, kitchen, dining area, living room, medication room, attached garage, and backyard. LPA completed a walk through of facility, review of records and medication audit. Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 74 degrees fahrenheit. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, chairs and sufficient lighting. LPA inspected resident bathrooms; bathrooms were clean and appliances were found functional. Water temperature tested at 117.3 degrees fahrenheit. The facility is equipped with operational smoke detectors, carbon monoxide alarms, fire extinguisher and first aid kit. Posters such as; the personal rights, ombudsman and emergency disaster plans were posted in a common area. LPA observed cleaning supplies left unlocked in the cabinet beneath the kitchen sink and knives left unlocked inside the drawer made accessible to residents. Technical violation issued. There was a designated storage space for resident/staff files. Medications were observed secured and inaccessible to residents. There are no guns or ammunition in the facility. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service : Non-perishable and perishable food supply is sufficient for number of residents in care. Facility has a wide variety of food available for residents. LPA observed medication stored inside the refrigerator made accessible to residents. Deficiency issued. Dishes, cups, and utensils were also stored properly. Yards/Outside: One shaded patio, a side gate with self-latching handle on the right side of the house that leads into the backyard. All outdoor pathways were free of obstructions. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Record Review: LPA reviewed 3 resident files for admission agreements, updated physician reports, pre-placement appraisals and needs and services plans. LPA also reviewed 3 staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. Medications were audited at random and appeared to be dispensed appropriately by staff. Emergency Disaster Drill was last conducted on 1/26/24. LPA observed the Emergency Disaster Plan last reviewed/updated on 02/01/23. Technical violation issued. One deficiency and two technical violations were cited during this visit. An exit interview was conducted where this report LIC809, LIC809C, LIC809D, LIC9102TV and appeal rights were discussed and copies were provided to staff, Isabelle Sanchez.