Facility Evaluation Report

Licensing Program Analysts (LPAs) Elena Mallet and Luis De Leon conducted a continuation annual required visit. LPA met with Director Dennis Robeniol and the purpose of the visit was discussed. The facility is licensed to serve elderly residents age 60 and above. It is approved for 136 non-ambulatory residents and 47 bedridden residents, approved for 10 hospice waivers.

Resident record review consisted of Admission Agreements, Physicians Report, Needs and Service Plan, Personal Rights, and Centrally Store Medication. Staff record review consisted of Personnel Report, Health Screening, and Background Clearance. Deficiencies were noted for resident’s for missing updated Needs and Service Plan for R4, TB results missing for R1 and R2, and ambulatory status for R5. Staff records were missing health screening for S1-S5, annual training missing for S2-S4, and first aid certificate missing for S2-S4. Deficiencies were noted on 809D pages.

Bedrooms were furnished with a bedframe, dresser, lamps, and chairs. LPA observed that there was clean linen, bath towels, and personal hygiene with reasonable closet space available for residents.

Wall and floors are in good repair. Hallways were clean and free of obstructions.