Facility Evaluation Report

At 12:30 p.m., Licensing Program Analyst (LPA) Evelin Rios arrived at the above mentioned facility to conduct an unannounced annual inspection. LPA was greeted by Licensee, Josephine Miranda and staff #1(S1). LPA explained the reason for the visit. An entrance interview was conducted.

At 12:45 p.m., LPA toured the facility inside and outside and observed the following:

Upon entry LPA observed appropriate postings except for the Complaint Poster (PUB 475) or a poster created by the facility with the same information. LPA provided a an email link to PUB 475 to Licensee. The facility has six (06) total bedrooms and three (03) total bathrooms.

Five (05) out of the six (06) bedrooms are for residents' use of which one (01) is shared. Bedrooms have appropriate furniture such as beds, night stands, chairs and enough storage for residents' belongings. In bedroom labeled 4, LPA observed an extra bedframe with mattress leaning against the wall on the left side of the resident's bed. According to Josephine the resident would be transferred to the newer furniture and a company would be by to pick up the extra furniture. LPA observed auditory alarms on exit doors working properly. Bathrooms were observed clean and were supplied with toilet paper, hand soap, paper towels, grab bars by toilets and showers and showers had non slip flooring. In the shared bathroom LPA observed boxes of incontinent care stacked on top of each other blocking access to a shower. Licensee stated she and S1 would be moving the boxes to a storage area tonight. At 3:22 p.m. LPA tested the hot water temperature in one (01) bathroom and it read 110.7 degrees Fahrenheit, within regulation.