Routine inspection·November 18, 2024

At 9:00am on 11/18/2024, Licensing Program Analyst (LPA) Jeffries arrived unannounced at the facility to conduct the annual facility inspection. LPA met with Licensee Angelita Maravillas, announced who he was and the reason for the visit being the annual facility inspection. At 9;30am Licensee and LPA conducted a full physical tour of the facility. The facility has 3 double occupancy resident rooms and one shared bathroom downstairs, upstairs, which is not licensed is for staff live-in, with 3 bedrooms, and 2 bathrooms one being an on suite bathroom, all for staff. On the first floor there are two living room areas, one room serves as a visitation room and the other living room serves as the general living room for residents in care. There is a kitchen an dining room area adjacent to the main living room. There is a laundry room where chemicals are located which is locked at all time. Centrally Stored Medications are located in a locked cabinet between the main living room and dinning area. There is a full first aide kit located in this locked cabinet. LPA noted that the stove was in need of cleaning and the staff began cleaning stove and finished before LPA finished annual inspection. LPA noted that there is at least 2 days of perishable foods and at least 7 days of non perishable foods on hand in the facility for residents and staff. LPA observed emergency water supply. LPA noted that the resident bedrooms had required chair, lighting, drawers, and bedding. LPA noted that there is liquid soap and paper towels in the residents bathroom. LPA observed back porch is elevated and has seating, table, with umbrella for shade for outdoor visitation. LPA noted that no doors or exits were blocked and all free and clear of obstruction. LPA viewed two fire extinguishers in the green, working smoke detectors in all resident rooms and two working carbon monoxide detectors tested by LPA. LPA reviewed all staff and resident files and confirmed all staff are cleared to be working in facility. LPA Reviewed Emergency Evacuation plan and Infection control plan and noted that both were reviewed and singed by licensee within the past 12 months. LPA noted that facility posting were on the wall adjacent to the 3 resident rooms and advised licensee for a more obvious centrally located location for facility posting. Continued on LIC809-C Licensee and LPA conducted a full review and the annual care tools modules. LPA noted that there was one violation pertaining to documentation of emergency quarterly drills. LPA noted that there were no other violations or citations as a result of the full annual care tools review. LPA issued citation for one violation during this annual inspection. LPA conducted interviews with 3 residents and 3 staff. Exit interview, report read, appeal rights and report provided.