Routine inspection·December 31, 2024

Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA identified themselves to, and discussed the purpose of the visit with Licensee Teresita Pedroso. According to the facility’s license, the facility has a maximum capacity of 6 non-ambulatory residents age 60 and over. Facility was approved for a hospice waiver for one. During today’s inspection, four (4) residents were at the facility, of which 1 (one) was non-ambulatory. LPA, accompanied by licensee, toured the interior and exterior of the facility and inspected common areas and a sampling of resident bedrooms. LPA also interviewed staff and residents and reviewed staff and resident files. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained required furniture. Doors, windows and screens, toilets, and showers were clean and in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. Confidential records and centrally stored medications were kept in locked areas. The facility had at least two days of perishable food and seven days of non-perishable food present. The facility had cooking and dining utensils to facilitate resident meal service. The facility’s ambient internal temperature was compliant at 70 F. Where tested, hot water temperature at taps (which were used by residents for personal care) were compliant: Bathroom #1 sink was 116.1 F, Bathroom #2, was 110.3 F and Bathroom #3 was 111.1 F. (continued on LIC 809-C, next page) There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to residents diagnosed with Dementia. No pools or bodies of water were observed on the premises. Per the licensee Teresita Pedroso, no firearms or ammunition are kept at the facility. Smoke and fire alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. A complete first aid kit was present and readily accessible. Licensee's staff also presented proof of current/active business liability insurance. Required licensing postings were observed in visible areas of the facility. No citation were issued during today's visit. An exit interview was conducted with Teresita, to whom a copy of this report and Licensee/Appeal Rights (LIC9058 03/22) were provided.