Facility Evaluation Report

On this day, Licensing Program Analyst (LPA) Delmundo arrived unannounced to continue the annual required inspection that was started on 3/08/24. LPA met with Mirriam Paras, administrator, and informed the reason for visit.

LPA reviewed 5 staff and 5 residents files, and interviewed 2 staff. Residents' medications were checked and compared with doctor's orders and LIC622 Centrally Stored Medication and Destruction Records. Facility does not handle residents' cash resources.

LPA obtained updated/current copies of the following documents:

1. LIC308 Designation of Facility Responsibility

2. LIC610E Emergency Disaster Plan (9 pages)

3. Proof of $3M liability Insurance coverage

4. Proof of Control of Property/Lease Agreement (expiration: 1/31/25)

-at 1:35 p.m., S1 has no First Aid certificate on file (expired 6/2017).

-at 1:45 p.m to 2:35 p.m., staff (S2, S3 and S5) do not have First Aid certificate. Required training for 2023 for postural support/restricted health condition/hospice care and medication training incomplete - only 2 hours medication, 2 hours postural support on file.

-at 2:40 p.m., staff (S4) no training record on file for 2019, 2020, 2021. No First Aid certificate on file.

-at 2:45 p.m., residents' (R1, R2, R3) LIC602A Physician's Report over a year old (on file dated 8/05/21 for R1, 2/20/23 for R2, 7/08/22 for R3).