Facility Evaluation Report

At 9:50 a.m. Licensing Program Analyst (LPA) Lorena Casillas arrived at the facility listed above to conduct an unannounced annual inspection. LPA was greeted by a caregiver and granted access. Caregiver requested LPA check temperature on temperature reader affixed to the entry wall and asked LPA to sign in. LPA called the Administrator Daisy Hailey and notified Administrator reason for the visit. Administrator would not be present and assigned Caregiver Eufemioike Rodriguez to sign the report. Caregiver is the only staff member currently present at the facility. There are four (4) residents present.

LPA observed that there is one (1) bedridden resident, but facility is not approved or have a fire clearance for bedridden. Facility is approved for two (2) ambulatory and four (4) non-ambulatory with three (3) hospice waivers. Three (3) residents are on Hospice Care. LPA explained to Caregiver that an immediate civil penalty of $500 would be issued.

At 11:30 a.m. LPA and Caregiver toured the physical plant of the facility, and the following was observed.

Common Areas : The facility maintains a comfortable temperature at 75°F. The living room and dining area appeared clean and were properly furnished. No obstructions or tripping hazards throughout the facility. LPA observed all trash cans throughout the facility have fitted lids.

Kitchen: The kitchen was observed to be clean and clear of clutter. Appliances and fixtures were functioning properly. LPA observed cleaning products kept locked under the kitchen sink. LPA observed knives locked in a kitchen drawer. LPA observed a sufficient amount of 2-day perishable and 7-day non-perishable food properly stored. On a wall leading to the kitchen LPA observed one (1) fire extinguishers fully charged with a last serviced date of 05/08/2023. Dining area had a table and chairs to sit the capacity of the facility.