Facility Evaluation Report

Licensing Program Analysts (LPA) Christina Valerio and LPA Kim Viarella arrived to the facility unannounced to conduct a pre-licensing inspection. LPAs met with facility staff, and explained the purpose the visit. LPAs were later met by licensee/administrator Sylvester and staff Chukwidi "Patrick" Ikiseh. The facility is currently going through a change of ownership.

The facility has a fire clearance for 6 non-ambulatory residents. Observed there are 4 residents in care at this time. Licensee Sylvester will be the designated Administrator for this facility. Certificate #6036359740 Expiration 07/05/2023.

LPAs toured and inspected the physical plant inside and outside to ensure there are no health and safety concerns. LPA’s observed the kitchen area, dining area, bedrooms, bathrooms, garage, and office. The facility is a 4 bedroom, 2 bathroom home with a kitchen area, dining area, and living room area. Residents have access to all areas except laundry room, medication closet, garage, and part of the backyard that is fenced off. All emergency exits have appropriate signage. The facility has an emergency disaster plan on file. LPAs observed smoke detectors and carbon monoxide detectors were functioning properly. LPAs observed no obstruction of emergency exits inside or outside of facility.

LPAs observed the area where the staff and resident files are locked and readily available for review. LPAs reviewed staff and resident files. Staff and Resident files were observed to be incomplete. This poses an potential health and safety risk to residents in care.

Resident bedrooms observed to have necessary furniture. Resident bedrooms are furnished with a bed, chair, night stand, personal dresser, and a closet space. Resident bathrooms observed to have non-skid mats, soap, paper towels, and closed lid garbage cans. Hot water temperature was measured to read 116.1* F, which is within the regulatory range of 105-120*F.