Routine inspection·September 22, 2022

Licensing Program Analyst (LPA) Angel Ascencio conducted an unannounced required annual visit to the above facility. LPA Ascencio met with the Administrator Maria Ayala and explained the reason for the visit. This annual had a specific emphasis on infection control practices and procedures. At 1:40 p.m., the LPA, along with staff member toured the physical plant areas inside and outside to ensure there are no health and safety hazards. BEDROOMS : All resident rooms are set up with beds, night stands, lamps, chests of drawers, chairs and closet space. The beds are furnished with box springs, comfortable mattress and clean linen; which includes, a mattress pad, top and bottom linens, pillowcases, blanket (if needed) and a bedspread. Lighting in the rooms appeared adequate. The bedrooms were large enough to allow for easy passage between the beds. In addition, no bedroom was used as a passageway to another room, bath or toilet. There are six (6) total bedrooms for resident use – all resident rooms are private rooms. RESTROOMS : There are three (3) total bathrooms at the home. One (1) is designated as a staff bathroom, 1 is in the common hallway, 1 restroom is in a private resident room. The resident bathrooms have a shower with non-skid materials. The toilet and showers have grab bars. Continued on LIC 809 - C COMMON SPACES: In the common areas, walls and flooring were checked for cleanliness and good condition. At the time of the visit, common seating area and dining room furniture was observed to be in good condition. Chairs were observed to be at least 6 (six) feet apart for social distancing. The LPA observed the required postings in the common hallway. Fire extinguishers were observed to be serviced within the last year. The facility smoke alarm system is hardwired and operated normally at the time of visit. Medications were observed to be locked in a closet by the kitchen and contained at least 30 days of worth of medication. The garage was observed locked and contained the emergency food supply. Laundry room contained a locked cabinet for laundry supplies. The backyard has a covered outdoor area equipped with furniture for resident use. There were no bodies of water noted. Hot water temperature was tested throughout the home and was within normal ranges between 105.0 F and 120.0 F. KITCHEN: Kitchen knives are stored in a locked closet by the kitchen. The supply of dishes, utensils, pots, pans and drink ware is adequate. The freezer was maintained at zero degrees Fahrenheit (0*F) and the refrigerator was maintained at 40*F. The supply of nonperishable food is adequate. There are no pesticides (poisons) or toxins stored in any food storage area or preparation area with utensils. Appliances in the kitchen were clean and all appeared functional. Trash cans had tight fitting lids. Kitchen, laundry and house cleaning supplies are stored in a locked cabinet located in the garage. No flies or other vermin were observed INFECTION CONTROL: During today’s visit, the LPA spoke with the Admin regarding the facility’s infection control practices at 2:25 p.m. There is 1 entry into the facility. Upon entry, the facility has a central entry point for symptom screening. The LPA noted that the facility is allowing visitors for both indoor and outdoor visitation. The LPA observed an adequate supply of Personal Protective Equipment (PPE) and the facility is able to obtain additional supplies as needed. The facility’s cleaning protocol is sufficient. Continued on LIC 809 - C If needed, the facility has the capacity to designate a single isolation room if the facility has a confirmed case of COVID-19. The facility does not have a confirmed case of COVID-19 at this time. The facility’s policies and procedures as it pertains to infection control are adequate. No citations were issued during today’s visit. Exit interview conducted, and a copy of the report provided to Admin via email.