Facility Evaluation Report

On this day Licensing Program Analyst (LPA) Fred Arias made an unannounced visit to conduct a required annual visit. LPA was greeted and granted entry into the facility by staff and explained the reason for the visit. Administrator (AD) Hashim Moosani arrived shortly to conduct facility tour.

LPA along with staff toured the facility at 1:25 PM. LPA toured the physical plant, checked food service, and facility documentation. The home consists of four resident bedrooms, staff room, living room, dining room, and kitchen, two bathrooms and an attached garage. 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 113.7 degrees F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards. Auditory exit alarms were operational during today's visit. LPA toured the kitchen and observed sharps locked in a cabinet during today's visit. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. One burner on the kitchen stove is non-operational. Smoke detectors tested operational during today's visit. Fire extinguishers were fully charged. LPA reviewed the infection control and emergency disaster plans and plans are complete and thorough. Facility does not have a record of emergency disaster drills. Outside grounds were toured. Walkways around the home were clear of hazards. There is shaded outdoor seating for residents. Exit gate is unlocked and operational. LPA observed the emergency food. First aid kit contained all required items including tweezers, scissors and thermometer. Facility conducts activities in the form of exercise. LPA reviewed five resident files and two staff files. Two out of five resident files contained all required documentation including admission agreements, physician reports, and resident appraisals. One out of two staff files did not include evidence of a health screening. The remaining staff file did not include evidence of CPR or required training.