Routine inspection·April 29, 2024

Licensing Program Analyst (LPA) Jacqueline Shaw Ross arrived unannounced to conduct an annual inspection. Upon arrival LPA was greeted by facility staff and granted entry. LPA began inspection with introduction and visit purpose. Upon arrival LPA learned that five (5) clients live at this facility. There are currently two (2) staff members present. The Administrator, William Lee conducted the tour. There is an Infection Control Plan on file. The facility is a one story, six bedroom, three bathroom home. Client Records-Incident Reports/Clients Rights-Information/Dental- LPA reviewed client records. Client records contained current physician reports and all required documents. Personnel Records/Training/and Staffing - LPA reviewed employee records. LPA reviewed employee records for first aid certification, criminal record clearance or an exemption, health screening and TB test results, employee rights, training verification, and current administrative organization. All records were on file and up to date. Food Service- Food prep areas are clean and organized. Food supply meets the requirement of one (1) week supply of nonperishable and two (2) day supply of perishables. Emergency food and water supply is present. There is a locked location for sharps in the kitchen. Physical Plant and Safety of Environment/Operational Requirements- LPA toured the facility inside and outside. LPA observed the facility to be clean and in good repair. The facility is maintained at a comfortable temperature for the clients. Lighting is sufficient for safety and comfort. Water temperature measured 118 degrees F. Laundry is done in the locked laundry room. (Continued on LIC809C) There is a locked cabinet for storing laundry soap and other chemicals, however LPA observed kitchen cleaning agents stored under the kitchen sink in an unlocked cabinet. Citation issued. All outdoor and indoor passageways are free of obstruction. Emergency lighting is available. There is a telephone working at this location. The LIC 610, emergency disaster plan is maintained. There are no firearms at this facility. There is a secured fireplace at this facility. There is not a pool at the facility. The facility performed the fire and emergency drills 2/15/2024. Smoke detectors and carbon monoxide detectors were tested and operable. Fire extinguishers were observed to be operable. Medications - are centrally stored. There is a locked cabinet allocated for medication storage. Centrally stored medication and destruction logs are maintained separately. LPA observed the following deficiency: --Medication was prepared and stored in pill containers for the evening distribution. Citation issued. An exit interview was conducted and a copy of this report was provided along with LIC 811, LIC 809D, and Appeal Rights to the Administrator..