Facility Evaluation Report

Licensing Program Analyst (LPA) Alberto Lopez conducted an unannounced annual inspection at the facility. Upon arrival, LPA met with Olga Soto and explained the purpose of the visit. The facility is licensed to serve 6 residents 60 years and older. Five (5) can be non-ambulatory and One (1) Bedridden, facility has hospice waiver for two (2). LPA use the CARE tool for this visit.

Infection Control: The facility staff are using appropriate hand hygiene and gloves while assisting residents and medications. Disposals of trash are done immediately after changing a resident. Staff were still cleaning and disinfecting throughout the day. Sufficient PPE supplies and. Facility does not have an Infection Control Plan posted by the entrance.

Physical Plant & Environment Safety: The 1-story facility is in good repair. Fire and carbon monoxide detectors are in every room. One smoke detector the hallway is not working. The 1-story facility consist of the following: 4 rooms, attached garage, 1 kitchen, 2 bathrooms, Facility has one screen in disrepair.

Operational Requirements: The facility did not have plan on file to accept or retain residents with dementia on file. The facility does not have current liability insurance covering injury to residents and guest on file. Staff employed are all over the age of 18.

Staffing : There appears to be sufficient staffing at the facility. The administrator’ Rafael Diaz did not have certificate on file and the ones posted had other names and are expired. .

Personnel Records-Training : Staff files are not main tained at the facility. All staff have current CPR/first aid training and but no evidence of on-going training