Facility Evaluation Report

Licensing Program Analysts (LPA)'s Shawna Doucette and Brianna Miranda arrived at the facility unannounced to conduct an annual inspection. LPA was granted entry by Staff Siranoush Musayelya. LPA explained the purpose of the visit and staff contacted Administrator Hasmik Nshanyan who responded to the facility to assist with the visit.

A tour of the facility was conducted with the Administrator. The residence was set at 72 F temperature and free of passageway obstructions inside and outside.

Kitchen toured, supply of food observed and food stored properly for perishable and nonperishable. Medications were stored in a locked cabinet in the kitchen. Cleaning supplies were locked in the laundry room. Smoke detectors and carbon monoxide detectors were checked and operating. Fire drill was last conducted 10/03/43. LPA checked water temperature which measured at 96.2 F.

There was outdoor seating for the residents.

Resident, medication and staff records were reviewed. LPA observed a medication error for R3 on two of R3's prescribed medications. Pill count was off by one on both of the prescribed medications. Current first aid and CPR were reviewed.

R1, R2 and R3 did not have Hospice Care Plans.

A copy of this report with plans of correction with appeal rights were provided to Administrator. Civil penalty was issued for repeat medication error.