Routine inspection·April 27, 2023

Licensing Program Analyst (LPA) Victoria Bertozzi arrived unannounced to conduct an Annual Required inspection and met with Licensee/Administrator, Joel Trinidad. LPA initiated a tour of the facility around 11:30am 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 111 and 113 degrees F which are within the range of 105 to 120 degrees F allowed per regulation. Extra hygiene products and linens were available. Kitchen cabinet containing cleaning supplies was locked. 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. Fire extinguisher was last inspected June 2022. Facility had a recent fire inspection from the local fire department who tested the combination Smoke/Carbon Monoxide detectors and found no issues. Most recent fire/disaster drill was conducted February, 2023. Five staff files and five resident files were reviewed. Staff have required First Aid and CPR Certificates and sufficient training hours. Administrator Certificate for Administrator, Joel Trinidad 60022722740 expired 11/22/2022 and is on the Department's pending list. Facility has two backup Administrators with active certificates. Medications and medication records were reviewed. LPA and Licensee discussed needed changes to their Infection Control Plan/Plan of Operation. Continued on LIC809C Continued from LIC809 Licensee/Administrator to submit updates of the following documents by 5/27/2023: Proof of Liability Insurance LIC308 Designation of Facility Responsibility (if applicable) LIC 500 Personnel Summary LIC 610 Emergency Disaster Plan (If changes) Infection Control Plan (If changes) No deficiencies cited during this this inspection.