Routine inspection·January 23, 2025

Licensing Program Analysts (LPAs) Christi Coppo and Ali Deniz arrived unannounced to conduct a required Annual inspection and was greeted by Administrator Sheila Sumabat. Facility contact information was reviewed. At approximately 9:30am LPAs and Admin toured the building and grounds. The facility was found to be clean and at a comfortable temperature. LPAs observed at least a 2 day supply of perishable and 7 day supply of non-perishable food. Food was found to be stored in a safe manner with open items covered. Kitchen cabinet containing sharp knives locked. All bedrooms were equipped with lighting, night stand, and chest of drawers. All bedrooms were clean and in good repair. Extra hygiene products and linens were available. Resident bathroom had required bath mat and grab bar. Water temperature in sinks accessible to residents in care measured at 111.9 degrees F in the main bath, 115.1 degrees F in the kitchen, and 114.7 degrees F in resident room #5 which are all within the allowable range of 105 to 120 degrees F. Fire extinguishers were last inspected 9/13/24. Smoke/Carbon Monoxide detectors located throughout the facility were operational per Admin. Facility’s last quarterly disaster drill was conducted with each staff on 1/7/25. LPA observed all training dates for respective staff were within the quarter. Facility has a backup generator for use during a power outage. At approximately 10:30am LPAs conducted a review of five [5] resident records. All required documentation present. 1/2 rail orders all on file for respective residents. Continued on 809C... Continued from 809... At approximately 11:00am LPAs conducted review of five [5] staff records. All required documentation present. At approximately 11:45am LPAs and Admin conducted a spot check of medication and medication records. Medication is centrally stored in a locked cabinet. No deficiencies Sheila Sumabat Administrator Certificate 7006961740 expires 12/20/2026. All fees are current as of this time. LPA and Administrator discussed facility's Infection Control Plan and Emergency Disaster plan. No new updates. No deficiencies cited . Exit interview conducted with Administrator and a copy of this report was given .