Routine inspection·November 20, 2024

Licensing Program Analyst (LPA) Araceli Canela arrived at this facility unannounced, to conduct an Annual Required 1 year inspection and met with care staff, Maria Datario. The facility is licensed for 6 non-ambulatory residents, 4 of which can receive hospice care services. There were 2 care staff at the time of inspection with 6 residents; 4 of which are on hospice services. This home is a two level home and the second level of the home is not used by residents and there is a gate at the bottom of the stairs to prevent access. LPA arrived at the facility and had temperature checked. Masks are requested to be worn prior to entry, but facility understands it is not mandatory. Facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Resident bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguishers were found to be charged and inspected within the last 12 months (6/21/2024). Facility has working smoke and carbon monoxide detectors. Toxins are stored locked and not accessible. There was a supply of hygiene products and paper products available for resident use. Facility has a large supply of extra linens. Facility has required posters in place at the entrance and throughout the building. The entrance area has a small table with hand sanitizer, thermometer and other items designated for visitors and staff before coming into work or visit. Medications are secure and not accessible to residents. Grounds were well-kept and free of debris, and provided plenty of outdoor seating for residents and visitors to enjoy in the summer months. LPA reviewed 6 of 6 resident files. Staff have proof of annual training, including Dementia training and proof CPR/1st aid expiring 4/6/2025 Continue report see LIC809-C LPA requested the following documents be sent to CCL by COB 12/19/2024: LIC 308 Designated Facility Responsibility LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan LIC 9020 Register of Facility Client’s/Resident’s Copy of Administrator Certificate(s) Copy of Certificate of Liability Insurance No deficiencies cited during today's visit.