Facility Evaluation Report

On 10/20/2023 at 9:10AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to conduct a Required - 1 Year inspection. LPA met with caregiver, Eljon Palad and explained the purpose of the visit. Administrator, Robert Abella arrived 30 minutes later. The facility’s fire clearance was approved for 6 non-ambulatory residents of which 2 residents maybe under hospice care.

LPA toured the facility including but not limited to bedrooms, bathrooms, dining area, kitchen, garage, and outdoor area. Smoke and carbon monoxide detectors were observed. Fire extinguisher was observed to be full and last serviced on 2/9/2023. One week of nonperishable and 2-day of perishable food supplies were available. Hot water temperature was measured at 110.9 degrees F in the hallway bathroom. LPA observed grab bars and non-skid mat in the bathrooms. There were adequate lights in each room. Resident rooms were observed to be cleaned and fully furnished. First Aid kit is complete. Last fire drill was conducted on 10/3/2023.

LPA reviewed 5 resident and 3 staff files starting at 10:10AM. LPA reviewed a sample of resident's medications starting at 12:25PM. LPA interviewed 2 residents and 2 staff at 1:36PM.

At 11:00AM, LPA observed R3 does not have TB test result on file during record review.

At 11:30AM, LPA observed facility does not have home health written agreement for R2.