Facility Evaluation Report

On this day, April 24, 2024, at 1:00 p..m., Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA met with Sunita Suman, facility nurse, and Theresa McIntosh-Adyemi, interim manager, and informed the reason for visit.

The facility is a two story building. LPA toured the facility inside out with the interim manager. LPA inspected the computer room, dining room, kitchen, art room, bedrooms, shower rooms, bathrooms, front, side and backyard. LPA also inspected the spare office/break-meeting room on the second floor. Supplies of food were observed good for 2 days of perishables and 7 days of non-perishables. Storages for c leaning supplies were observed locked.

Fire extinguishers were observed fully charge with tags showed serviced January 30, 2024 Facility has 2 in 1 carbon monoxide and smoke detector that was tested and observed functional. Hot water temperature in one of the common bathrooms was tested and measured at 108.7 degrees Fahrenheit.

Facility has LIC808 Mitigation Plan. LPA requested for LIC9282 in April 14. 2023 which the facility has not submitted up to this day.

LPA reviewed 5 residents and 5 staff files, and interviewed 3 residents and 3 staff. Medications were checked and compared with doctor's orders and LIC622 Centrally Stored Medication and Destruction Records. Facility does not handle residents' cash resources.