Facility Evaluation Report

On this day, January 27, 2024, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA met with staff, Marta Dacuma, and informed the reason for visit. LPA called and spoke over the phone with Precilla San Miguel, licensee-administrator, who authorized Marta Dacume to with LPA in touring the facility. Administrator arrived at 11:30 a.m.

Facility has not submitted the LIC9282 Infection Control Plan.

LPA toured the facility inside out with Marta Dacuma. LPA inspected the kitchen, dining area, activity/game room, bedrooms, bathrooms, side and backyards. Food supplies were observed good for 2 days of perishables and 7 days of non-perishables.

Facility has smoke and carbon monoxide detectors that were tested, and observed functional. Hot water temperature in one of the bathrooms was tested and measured at 113 degrees Fahrenheit.

LPA reviewed 3 staff and 5 residents records, and interviewed 2 staff and 2 residents. Medications were checked and compared with doctor's orders and LIC622 Centrally Stored and Medication Records. Facility does not handle residents' cash resources.

-at 10:38 a.m.,central storage for medications unlocked.

-at 10:40 a.m., residents' medications in unlocked kitchen cabinet.

-at 10:44 a.m., unlocked refrigerator with residents' medications and staff medications/vitamin supplements in unlocked staff bedroom.