Facility Evaluation Report

On 09/20/2022, Licensing Program Analyst (LPA) Jessica Cho conducted an unannounced visit to Family Care- Buckboard Home. The purpose of today's visit was to conduct a Required 1 Year focusing primarily on the Infection Control. At 9:44am, LPA Cho was greeted and allowed entry by Care Staff Gloria Sabido and completed the Coronavirus 2019 (COVID-19) screening procedure. Care staff Sabido contacted and informed Licensee Russel Venanzi of LPA's arrival. Care Staff Rubie Mae Saban and Staff 2 (S2) were also present at the facility today. Staff 1 (S1) was fingerprint cleared but was not associated to this facility. Staff 2 (S2) did not have a Criminal Background Clearance. Per interviews of Staff 3 (S3) and Licensee, S2 was visiting and assisting with chores. S2 left the facility around 10:00am. As of today, there are no active COVID-19 cases. Per Care Staff Sabido, facility does not screen and document temperatures for visitors on a sign in sheet. LPA observed the required COVID-19 precautionary signs throughout the facility. The facility did not have the Complaint Poster (PUB475). The facility is licensed for six non-ambulatory residents and has a hospice waiver for two. There are currently five residents living in the facility of which one is receiving hospice care.

At 10:05am, LPA Cho conducted a tour of the physical plant with Care Staff Sabido. The single-story home consists of five resident bedrooms and two resident bathrooms. There is one staff bedroom. The facility also has a living room, dining area, office area, kitchen, laundry room, and an attached two car garage. The resident bedrooms had the required furnishings, 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, showers were free of mold/mildew, and non-skid mats were in place. Resident bath towels and personal hygiene supplies were adequately stocked including paper towels and hand soaps. LPA observed hand washing signs in both bathrooms. LPA tested the hot water temperature in the resident bathrooms and the temperature measured at 116.0 degrees Fahrenheit in the Bathroom #1 and 116.7 degrees Fahrenheit in Bathroom #2.