Routine inspection·February 23, 2024

Licensing Program Analyst (LPA) Jacqueline Shaw Ross arrived at the facility unannounced to conduct an annual inspection. LPA was greeted by Mercelita Williams, Administrator, and explained the purpose of the visit. The facility is licensed for age 60 and over, three (3) may be ambulatory and three (3) non-ambulatory, of which one (1) may be bedridden. Bedroom #5 is the only room approved for bedridden. Bedroom #3 and #4 are approved for non-ambulatory. There is a Hospice waiver for 3. The facility is five bedroom two bathroom one-story home. Four bedrooms designated for the residents and two of the bedrooms are shared occupancy. The licensee occupies one bedroom with her husband. There is a kitchen, dining area, and living room, with a 2 car garage. LPA conducted a tour of the home inside and out. During today's inspection, LPA observed the following: Indoor and outdoor passageways were observed to be free from obstruction. There are no pools or bodies of water. Per Administrator, there are no firearms or other dangerous weapons in the facility. Poisons and cleaning agents were observed to be secured and inaccessible to residents in care. Kitchen was observed to be fully operable and clean. LPA toured every room in the facility. Rooms designated as resident rooms had the required furnishings and sufficient lighting available. Licensee provided each resident with clean linen, in good repair, and sufficient hygiene products for personal use. During a tour of the bedrooms the following were observed: -Video cameras were mounted in each of the resident's bedrooms. LPA informed Administrator this is a violation of residents right to privacy. Deficiency Cited. The hot water temperature measured at 119 degrees F. The facility had a functioning carbon monoxide detector, multiple smoke detectors, and multiple operable fire extinguishers. The facility was stocked with a two-day supply of perishable food items and a seven-day supply of nonperishable food items. Staff records were reviewed and contained CPR/First Aid training, Health Screening Reports, and annual training. Resident records were reviewed and had a current Physician's Report, Resident Appraisal, Identification and Emergency Information, Admission Agreement, and Centrally Stored Medication and Destruction Records. However during review LPA noticed the following: -One resident's file was did not have Pre-Appraisal form filled out, only signed. Deficiency cited. Medications were stored in a locked cabinet and were labeled and maintained in compliance with label instructions. During review of medications LPA observed the following: -Medications were stored in a medication pill container and not in it's original container. Deficiency cited. The above deficiencies were cited during today's visit. This report was discussed with the Administrator. A copy of this report, LIC809D, along with Licensee/Appeal Rights, was provided to at the conclusion of the visit.