Facility Evaluation Report

At approximately 2:00 PM, Licensing Program Analysts (LPAs) Julie Florio and Ali Deniz arrived unannounced to conduct a required 1-year annual inspection and were greeted by staff. Cheryl Gambonini, Licensee/Administrator was contacted via telephone and arrived approximately 15 minutes later. Facility is a Residential Care Facility for the Elderly (RCFE) with four (4) residents in care, all of whom were present during today's inspection. Facility has a Dementia Care Plan, a Hospice waiver for three (3), and is approved for all non-ambulatory residents,.

At approximately 2:30 PM, LPAs initiated a tour of the facility with Administrator and observed the following: Facility is a one story home, was a comfortable temperature, and passageways were free from obstructions. Water temperatures in residents' bathrooms measured within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPAs observed a supply of clean linens, and hygiene, incontinent care, and paper products available for residents. Residents' bedrooms were inspected and observed to have all the appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. Facility has at least two days of perishable food and one week of non-perishable foods, as well as an emergency water supply. LPAs observed at least 15 instances of expired perishable and non-perishable food items, (see LIC809D). Medications were centrally stored and locked. There is a shaded seating area in the front and backyards with outdoor space for activities. LPAs observed another structure which was locked and is used as a bakery and the contents of which is mostly baking supplies and holiday decorations. Resident were observed engaged in community word games during inspection. Facility has an internet access device available for resident use. Facility has internet service available to residents in care and the telephone was tested an operational during inspection.