Routine inspection·November 6, 2023

Licensing Program Analyst (LPA) Victoria Bertozzi arrived unannounced to conduct an Annual Required inspection and was greeted by caregiver, Ana Caadyang. Licensee/Administrator, Josephine Credo was unavailable but staff were able to assist LPA with visit. LPA initiated a tour of the facility around 9:15am and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Resident rooms were furnished per regulation. Water temperature in bathrooms used by residents measured at 107 and 109 degrees F which are within the range of 105 to 120 degrees F allowed per regulation. Extra hygiene products and linens were available. Cabinets containing cleaning supplies were inaccessible. Facility has at least two days of perishable and one week of non-perishable foods which appeared to be of quality and stored per regulation. Medications were centrally stored and locked. Emergency food and water supplies are stored in the garage. Personal Protective Equipment is also stored in the garage. Fire extinguishers were last serviced February 2023. Smoke and Carbon Monoxide detectors located throughout the facility were tested and operational during inspection. Facility did not have the date of their most recent fire/disaster drill but per staff, it was conducted September or October, 2023. LPA directed staff to document all drills in the future. Five staff files and five resident files were reviewed. Staff have required First Aid and CPR certificates. Administrator Certificate for Administrator, Josephine Credo is expired but is on the Department's pending list. Medications and medication records were reviewed. Training records were also reviewed. Continued on LIC809C Continued from LIC809 Licensee/Administrator to submit updates of the following documents by 12/06/2023: LIC 500 Personnel Summary Copy of Liability Insurance Current Lease LIC 610 Emergency Disaster Plan (If changes) Infection Control Plan (If changes) No deficiencies cited during this inspection