Facility Evaluation Report

On this day, May 4, 2023, at 10:45 a.m, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA was granted entry by Mohammed Arafat, licensee, and informed the reason for visit. LPA called and spoke over the phone with Doreen Khan, licensee- administrator, who indicated she's with 2 of the residents for appointments. The administrator arrived at around 11:50 am after dropping off the residents to their day program.

Facility has an approved LIC808 Mitigation Plan, and on facility file, an LIC9282 Infection Control Plan; however, copy of LIC9282 has not been submitted to the Department.

LPA inspected the facility inside and out including but not limited to bedrooms, bathrooms, laundry room, kitchen, dining and living rooms. front and backyard. Facility has sufficient perishable and non-perishable foods. Fire extinguisher was observed fully chargem and receipt showed purchased on May 3, 2023. Facility has carbon monoxide and 2 in 1 smoke and carbon monoxide detectors that were tested and observed functional. Hot water temperature in the common bathroom was tested and measured at 107 degrees Fahrenheit. Facility conducts disaster drills monthly, and records showed last conducted April 19, 2023. Cabinets were sharps and medications are kept were observed locked.

LPA reviewed 4 residents and 4 staff files, and interviewed 2 staff and 2 residents. Medications were checked and compared with records. Residents' cash resources match the records.