Routine inspection·May 8, 2024

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced annual inspection visit, and met with Administrator (ADM) Mariluz Arimas. During the visit, LPA observed 6 residents and 3 staff. LPA toured the facility inside out with ADM which included the Living room, kitchen, dining room, 2 restrooms and 5 resident bedrooms. The staff area of the facility was also inspected. The front yard and backyard were inspected. There was no obstruction to block the walkways. Two-day perishable food supplies and seven day nonperishable food supplies were observed. LPA observed the medication storage area, knives storage area, and cleaning product storage area as locked and inaccessible to residents in care. Room temperature was at 74 degrees F, and hot water temperature was measured at 118 degrees F in both resident bathrooms. Fire extinguisher was serviced in July 20, 2023. The facility was equipped with smoke and carbon monoxide detectors. Smoke detectors was tested by ADM, and were functional. LPA requested to see the facility first aid kit and facility fire/earthquake drill log. LPA reviewed the facility fire/earthquake drill log, which only had the last documented drill at January 8, 2021. ADM stated the facility's last drill was on January 13, 2024. ADM stated she could not find the documentation for fire/earthquake drills for the year 2023-2024. LPA reviewed facility records for 3 staff and 3 residents. While reviewing resident R3's records, LPA observed resident R3 has dementia. R3's last physicians report is dated November 15, 2022. ADM stated she did not have an updated physicians report for resident R3. LPA requested to review residents R1-R3's weight record log. ADM stated she does not have a weight record log. Page 1 Out of 2 LPA reviewed 3 resident medications and centrally stored medication records. LPA conducted interviews with 1 staff and 2 residents. Deficiencies are being cited during today's visit, see LIC809-D. This report was reviewed with Administrator Mariluz Arimas and a copy of the signed report was provided. Appeal Rights were provided. Page 2 Out of 2. END OF REPORT