Facility Evaluation Report

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry by facility administrator Emiliana Pinera after stating the purpose of the visit.

There are currently three residents in care, none of which are receiving hospice care at this time. LPA observed residents relaxing in the facility's common living areas or in their respective bedrooms. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with an attached garage. The facility has four bedrooms along with one locked staff room along with two shared bathrooms and one en-suite bathroom off of a shared room which currently only houses one occupant.

Bedrooms appear clean and sanitary. Two residents are observed using half-rails postural supports at the time of the visit, consultation provided and licensee instructed to submit adequate physician orders at the earliest convenience. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary and are equipped with grab bars and slip mats. Hot water temperature measured at 111F in two separate bathrooms equipped with faucets used for personal grooming.

LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items, cleaning supplies and the medication central storage are verified to be secured.

The wall-mounted fire extinguisher is charged with up-to-date maintenance. Smoke and carbon monoxide detectors were found to be operational. The garage is inaccessible to residents and used for laundry as well as additional storage of supplies. CONTINUED ON FORM LIC809-C