Facility Evaluation Report

Licensing Program Analyst (LPA) Michael Tea conducted an unannounced visit. The purpose of today’s visit was to conduct the Annual Required inspection. LPA Tea was greeted and granted entry into the facility by administrator, Geisel Sanchez and explained the reason for the visit. Facility is licensed for 6 non-ambulatory residents, with a hospice waiver for six and bed-ridden for one. Currently there are six residents, of which four are on hospice during today's visit.

LPA Tea along with the Administrator toured the facility at 2:18 PM. LPA toured the physical plant, checked food service, and the first aid kit. The home consists of 5 resident bedrooms, 1 staff resting room, 1 office room, 2 bathrooms, living room, dining room, and kitchen. LPA observed smoke detectors/carbon monoxide in common areas and bedrooms are operational. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured around 109.5 F degrees. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had all the required elements including tweezers, thermometer, and scissors. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. LPA observed sharps locked in a kitchen cabinet. LPA also observed toxin substances to be locked and inaccessible to clients in care locked and secured in cabinets in the garage. The fire extinguishers throughout the facility were fully charged. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there is ample seating with shade and one exit gate on the right side of the facility is self-latching and operational. LPA observed emergency supplies, food and water in the garage. Facility provides activities based on resident interests. The residents watch television, listen to music, reading books and newspapers and completing puzzles. At the time of annual visit, residents were seen playing cards and doing puzzles.

Continuation of annual inspection on LIC-809C