Post-licensing visit·March 7, 2023

Licensing Program Analyst(LPA) Alviso conducted a Post Licensing visit, at about 1:15am on 3/7/23, and met with Administrator Mera Shaughnessey. There are six(6) residents in care. Facility has an approved Hospice Care Waiver for three(3). Facility has an approved Dementia Plan of Operation. Facility has submitted the required Infection Control Plan. Fire clearance is approved for six(6) non-ambulatory and/or bedridden residents, all rooms are cleared for bedridden use. All resident files were reviewed, and found to be complete. LPA reviewed staff files, including training. All staff have criminal record clearance as required. All staff are first aid and CPR certified. Caregivers are trained to assist residents with medication. Facility files reviewed showed facility evacuation drill and emergency drills are scheduled, to be completed, they are done every three months. Last evacuation drill and emergency drill was done end of October 2022 before doing the change of location. Administrator stated to the LPA that they have reviewed with staff, and run through the evacuation plan and emergency drills with staff, once the facility was licensed, 12/27/22.. LPA toured the facility with the Administrator Mera. The home was found to be clean and orderly. LPA observed sufficient food; LPA observed the residents being served lunch. LPA observed a sufficient supply of hygiene products, cleaners/disinfectants, and paper products. Continued on LIC809C... The fire extinguishers, two(2), are serviced and tagged as required expires 12/5/23. All exits were clear from obstruction. Smoke alarms (9) are hard wired, and are also carbon monoxide detectors. Facility has emergency supplies, 72 hour shelter in place supplies .Facility medications are locked and inaccessible to residents in care. All toxins are locked and inaccessible to residents in care. All bathrooms have grab bars, non-slip flooring and/or mats for resident use as needed. There was sufficient lighting in resident rooms, bathrooms and hallways. The LPA observed the home to be at a comfortable temperature upon entry into the home, and when touring the facility during the visit. There are two heater controls, one in the kitchen and one in the hallway. All utilities were on and working appropriately. All appliances were working appropriately. Facility had a sufficient supply of personal protective equipment(PPE) for staff use as needed. Per Administrator, all staff have been in-serviced on the infection control plan, emergency drills, and evacuation plan. No deficiencies cited today. Exit interview conducted.