Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Wong conducted an unannounced annual visit at the facility with focus on the infection control domain. LPA met with caregiver Maryanne Veigara and Joel Basilio explained the reason for the visit.

The facility is licensed to serve 6 residents over the age of 60 years old of which 2 ambulatory and 4 non-ambulatory, and a hospice waiver for one resident. There are currently one residents on hospice. Facility cares for dementia residents and has security alarm on each exit doors. There is a swimming pool in the back yard but its gated and locked.

LPA and caregiver Joel Basilio conducted a tour of the facility and observed the following:

All common areas are clean and in good repair. Kitchen was observed clean, food was reviewed and sufficient for at least 2 days of perishables and 7 days of non-perishables. All residents bedrooms were observed, all bedrooms have sufficient lighting, furniture, and bedding. All three Bathrooms in the facility were observed. The bathroom#1 and #2, the hot water faucet are not working. Water temperature was tested in the three bathrooms and tested between 78.5 and 118.6 degrees F. which is not within the required 105-120 degrees F.

LPA reviewed all 6 residents' files and all their emergency contact information are updated. LPA reviewed 3 staff files and LPA was not able to review administrator file including the administrator certificate and health screening form. LPA reviewed all 6 residents medication and all residents medication are updated and accurate.