Facility Evaluation Report

On 9/26/23 at 11:20 a.m. Licensing Program Analysts (LPAs) B. Miranda & V. Gorban arrived to the facility unannounced to conduct an annual inspection. LPAs were greeted and allowed entry into the facility. Administrator- Emmanuel Inneh was contacted and conducted the tour with LPAs. Administrator could not stay to review and sign reports. Administrator gave permission for staff Larry to sign reports.

LPAs toured the facility inside and out. Administrator will provide report from smoke detectors being tested. Carbon monoxide readers were not in working conditions. Areas of the facility needs to be clean. LPA observed kitchen to be cluttered and unclean. Refrigerators and had buildup and needed to be cleaned. LPAs observed expired milk and non-perishable food items.

LPAs observed couches in the facility to have holes and be taped with duct tape.

LPAs observed one women's shared bedroom to have a pungent urine odor.

LPAs observed fecal matter to be on one bathroom floor and the floor in the laundry room.

LPAs observed water temperature in a men's bathroom to read at 132.2.

LPAs observed mold on the bathroom walls and behind medicine cabinet mirrors. .

LPAs observed for no doctor's orders for resident's PRN/OTC.

LPAs observed closest with cleaning supplies and bug spray to not be locked and accessible to residents in care.

LPAs observed two resident's mattresses to be worn out and not in good condition.

LPAs observed mattress' in extra rooms to be moldy, stained, and not usable.

LPA's observed one resident's room to have a powder along the wall to repel insects.

Exit interview was conducted with staff Larry. This report LIC809, LIC 809D, and appeal rights were printed and provided to Staff Larry.