Routine inspection·October 8, 2024

On 10/08/2024, Licensing Program Analyst (LPA) Jaime Vado conducted an unannounced required - 1 year inspection visit. LPA met with administrator Maryann Lucero and explained the purpose of today's visit. There are currently 45 residents in the facility during today's visit and multiple staff. This is a multi-level facility licensed for residents age range of 60 years and over. Facility is approved for 48 non-ambulatory residents. Hospice waiver is approved for 20 residents. There is only currently 1 residents receiving hospice services. There are no video cameras on site per the administrator. LPA observed the facility kitchen which is clean and observed appliances that are in good repair. Knives are stored and locked in a drawer next to the stove. Perishable and non-perishable food items are observed as in place. Food supplies are stored the kitchen area. Refrigerators and freezers are in operating condition. First aid kit is observed as complete with required items stored in the kitchen of the facility. Medications are observed to be locked in the kitchen in a kitchen cabinet. LPA observed multiple fire extinguishers in place which are all currently within operating range, smoke detector are hard wired through out the facility, carbon monoxide detectors are observed in place through out the facility, and central heating. Facility is equipped with fire sprinklers through out. LPA also observed fire pull stations around the facility. PPE is observed to be in place. Emergency exit routes are observed inside and outside to be free and clear of obstructions. Emergency disaster drills are conducted quarterly and current. This poses an immediate health and safety risk. Water temperature was measured at 112F. Cleaning supplies are observed to be locked in the kitchen and garage. Continued on next... Page 2 LPA observed all resident rooms as clean, free of odors, and contained all the required furniture per regulatory recommendations. Resident bathrooms are observed as clean and in good worker order. Shower floors are equipped with non-skid mats or flooring. Facility handles some resident monies. These monies are audited and accounted for per review conducted. LPA reviewed 8 resident files and 6 staff files, which are all current. Facility administrator certificate is observed as current expiring 10/26/25. The following updated forms are requested to be submitted to CCLD by 10/15/2024 : • Copy of all updated administrator certificates • Copy of facility's liability insurance • LIC308 Designation of responsible staff person • LIC610E Emergency Disaster Plan • LIC500 Staff Schedule • Copy of control of property or copy of lease There are no citations issued during today's visit. Report is reviewed with the administrator and a copy is provided during today's visit.