Routine inspection·November 14, 2024

Licensing Program Analyst (LPA) Teresa Camara conducted a required annual visit. LPA was initially met by staff who called the back-up administrator Karthik "Raj" Kanakaraj. The administrator arrived at the facility at approximately 11:45 a.m. LPA explained the reason for the visit. Starting at 11:14 a.m. LPA conducted a tour of the physical plant accompanied by staff. The facility is single-story with six resident bedrooms, three bathrooms and one staff room. The smoke detectors and carbon monoxide detector were tested and functioned properly during the visit. The fire extinguisher was last serviced 4/1/2024 and appeared fully charged. No hazards were observed. Kitchen : The kitchen appeared clean and the appliances and fixtures functional. The LPA observed a sufficient amount of perishable and non-perishable food at the facility. Knives are stored in a locked cabinet. Bedrooms: The resident bedrooms were properly furnished with clean linens and adequate lighting. Bathrooms: LPA observed bathrooms were clean, properly supplied and had functional fixtures. The LPA observed grab bars and non-skid mats in all bathrooms. Residents have sufficient amounts of supplies for personal hygiene. The hot water temperature was measured in two common bathrooms at 110.0 to 112.1 degrees Fahrenheit, which is within the required limit of 105-120 degrees Fahrenheit. Common Areas: These included the living room and dining area. The common areas were checked for cleanliness and furniture was checked for functionality during time of visit. There is a fireplace in the living room, which is covered with a screen. The facility maintained a comfortable temperature. (continued on LIC809C) (continued from LIC809) Garage/Laundry room: The facility has a laundry room where the washer and dryer are held. The laundry room leads to the garage where cleaning supplies and disinfectants are kept, and additional PPE supplies are stored. The Garage remains locked and inaccessible to the residents in care. Surrounding Grounds (Outdoors) : There was a shaded area with proper furniture for outdoor use. There are no bodies of water on the premises. Interviews: During the facility tour the LPA attempted to speak with residents but due to cognitive issues was unable to interview the residents. LPA conducted interviews with two staff. No immediate concerns identified. Records: LPA reviewed five residents' files and reviewed medications. Files were complete and medications appear to be given as prescribed. LPA reviewed files for three caregivers and the administrator. Files were complete with no immediate concerns. LPA reviewed the emergency disaster plan and evacuation drills are conducted quarterly with staff on all shifts. No deficiencies were observed. Exit interview conducted and report issued.