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 Lorna Constantino was notified of the visit via telephone and informed LPA she would not be able to assist with the visit due to a family emergency. Administrator gave permission to her staff to assist with the annual visit and to sign the report on her behalf.

There are currently six residents in care, two of which are receiving hospice care. LPA observed residents relaxing in their respective bedrooms or in the facility's common living areas. 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 en-suite bathrooms and one shared bathroom throughout the facility.

Bedrooms appeared clean and sanitary, however one bedroom is not equipped with a bed as facility staff indicates that resident requested a recliner seat instead upon admission. Facility staff however did not submit an exception request at the time of the visit. Type B deficiency cited. There are two beds equipped with half rails and one bed with full rails installed for postural support. Full rail orders are present in the relevant resident's hospice plan of care, however the other two half rails are not documented by physician orders available during the present visit. Type B defiency cited. Bathrooms appear clean and sanitary. Hot water temperature measured at 105F and 106F in two separate bathrooms with faucets used for personal grooming. Advisory provided.