Facility Evaluation Report

On 12/30/2024 at 9:00 AM, Licensing Program Analyst (LPA) A. Gomez arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Backup Administrator, Ana Breen and explained the purpose of the visit. The facility’s fire clearance was approved for all may be non-ambulatory with a hospice waiver for 3.

LPA toured facility with Ana including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 7 total bedrooms which 4 bedrooms are occupied by the residents and 1 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 76 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 133.7 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable.

Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 11/20/2024. Emergency Disaster Plan was last posted on 1/02/2024. First aid kit was observed to be complete. Emergency disaster drill was last conducted in September 2024.

At 10:41am, LPA reviewed 4 residents records. At 11:00 am, LPA reviewed 3 staff records and 2 of 3 have current first aid training and associated to the facility. LPA reviewed a sample of resident’s medications.