Routine inspection·June 19, 2024

At approximately 1:35 PM, Licensing Program Analyst (LPA) Stefanie Mutialu made an unannounced annual required inspection of this licensed senior care facility. LPA was greeted by caregiver, Pauleen Costals, Caregiver. Administrator, Leonila Buny arrived shortly after at approximately 1:50 PM. The facility is a single story home licensed for six (6) non-ambulatory residents and a hospice waiver capacity of three (3). The facility currently provides care for four (4) residents. Three out of four residents were at day program and one out of four residents was at home watching television in the living room. In addition, there are two (2) residents with a diagnosis of dementia and one resident on hospice. At approximately 2:00 PM, LPA and administrator toured the building and grounds which was found to be clean and in good repair. All notices that are required to be posted have been posted and are in a highly visible area. Resident’s bedrooms, common areas, kitchen & food storage areas were inspected. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. Toxins are stored in a locked cabinet in the facility laundry room and garage. Sharps and other kitchen supplies that could pose danger if available to residents were found secured in the kitchen drawer. There was a supply of cleaners, hygiene products and paper products available for residents. All resident’s bedrooms have lighting & appropriate furnishings. Water temperature measured within regulation between 105 and 107 degrees F at three of three faucets accessible to residents. Two out of two fire extinguishers were inspected and charged. Nine out Nine Smoke/Carbon Monoxide interconnected detectors were present, inspected and found to be in working order. There was enough lighting in all common areas, resident rooms, and hallways. Continued on 809 C Continued from 809 Medications located in designated cabinet were found to be secured. LPA conducted a spot check of medications and found administering and records to be accurate. Resident was observed interacting with staff in living room. Three of four returned from day program approximately at 2:30 PM. Facility offers a activity sun room and take residents on weekend and weekday outings. LPA observed staff checking and caring for residents often. At approximately 2:45 PM, LPA reviewed Four of Four resident records which were all found to be well organized. At approximately 3:15 PM, LPA reviewed four out of four staff records which were all found to be well organized. Two of four staff members are in the onboarding training process Medication records contained physician's orders for each resident. P&I is not comingled. Administrator Leonila Bunyi Administrator Certification 7033416740 is current and expires on 10/20/2024. No citations were issued during today’s visit. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report Evidence of Liability Insurance Surety Bond