Facility Evaluation Report

LPA Alberto Lopez made unannounced visit to conduct the annual inspection. LPA met with Conchita Pasion and Bob Allado Live in caregivers and explained the purpose of visit.

The facility is licensed to serve 6 (six) non-ambulatory residents ages 60 and over of which 1 (one) may be bedridden and facility is approved to retain 2 residents on hospice.

LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following:

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 are still cleaning and disinfecting throughout the day. Facility has sufficient PPE supplies but did not have an infection Control Plan at facility.

Operational Requirements: The facility has a dementia care plan to accept or retain residents with dementia. There are currently 2 non-ambulatory 1 ambulatory and 3 bedridden residents residing at the facility. The facility has the sufficient amount of liability insurance covering injury to residents and guest.

Physical Plant & Environment Safety: There are no pool or bodies of water at the premises. There are 6 resident rooms bedrooms and two staff bedroom, 4 bathrooms, living room, dining room, and kitchen, Facility has operable smoke and carbon monoxide detectors located in each room and hallway. Knives, cleaning solutions, and disinfectants are locked in the cabinets. No firearms or weapons are stored at the facility. LPA measured the hot water temperature in the bathrooms and kitchen sink. The hot water temperature in the bathrooms were measured between 108.1 - 113.7 degrees F which is within required range of 105-120 degrees F.