Routine inspection·June 29, 2021

Licensing Program Analysts (LPA's) Sarah Hurt and Ruth Wallace conducted an unannounced visit today to complete an annual inspection. LPA's met with Assistant Administrator Leticia Cabangal. There are currently 4 residents who reside at this home and there is one resident on hospice at this time. LPA'S inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, medication storage, kitchen, garage and outdoor areas. Bedrooms were clean and in good repair. There is a locked storage for medications. Food supply is adequate for 2-day perishable and 7-day nonperishable. Fire extinguishers expires 06/17/2022. Smoke alarms were tested and are operational. The home has a carbon monoxide detector and performs disaster drills as required. Water temperature was tested at 108 F degrees. First Aid kit is on site and complete. Toxins are locked. This facility is operating within the scope of their license. LPA's reviewed four resident files. Resident's medical files and medications were reviewed. All resident files reviewed were in compliance. Four staff files were reviewed and each had the required criminal record clearances. First Aid and CPR training was current and staff has current training No deficiencies were identified on this inspection. The Administrator shall send in updated copies by July 13, 2021 of the LIC 500 Personnel Report, LIC 308, LIC 309, Liability Insurance, Designation of Administrative Responsibility, LIC 610-E, facility deed or lease agreement, the Emergency Disaster Plan if needed and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing. Exit interview conducted with Assistant Administrator and copy of report left at facility.