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 caregiving staff after introducing himself and stating the purpose of the visit. Administrator Simona Aziz was notified and arrived later to assist with the visit.

There are currently six residents in care, three of which are receiving hospice care. LPA observed residents relaxing in the facility's common living areas as well as in their respective bedrooms. Three resident interviews conducted during the visit. LPA accompanied by facility staff toured the physical plant. The facility is a one-story house with an attached garage. The facility has six private rooms. There are two shared bathrooms along with one ensuite bathroom throughout the facility. All showers have slip mats as well as hand rails in place.

Bedrooms appeared clean and sanitary. Three residents receiving hospice care are using full bed rails for postural supports. Another resident uses half rails. Hospice plans of care reviewed, physician orders for the half rails to be provided at the licensee's earliest convenience. All resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary. Hot water temperature measured at 106F in one bathroom with a faucet 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 products and the laundry area are secured, along with the medication central storage. Fire extinguishers are charged and mounted, with up-to-date maintenance documented on the attached tags. LPA tested the smoke and carbon monoxide detectors which were found to be operational. The attached garage is inaccessible to residents. CONTINUED ON FORM LIC809-C