Facility Evaluation Report

On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of conducting the Required Annual Inspection. LPA was greeted and granted entry by the facility's caregiving staff after introducing himself and stating the reason of the visit. Administrator Miguelito Fajardo was notified via telephone and arrived later to assist with the visit.

During the inspection, LPA and staff conducted a tour of the physical plant and observed the following: The facility is a one-story home with three private and one shared bedrooms in addition to the facility's common living areas. There is an additional room for use by live-in staff. There is one shared bathroom and one bathroom located en-suite with the shared bedroom. Both are observed to be equipped with grab bars and slip mats. All resident bedrooms have the required furnishings. LPA observed all beds have linen and blankets. One bed is observed to be equipped with half rails and another one with full rails for postural support. Physician orders and hospice plan of care and admission reviewed for both residents.

There are currently four residents admitted to the facility, two of which are receiving hospice care. One of these residents is assessed to be bedridden in their most recent physician report and the previous one. The facility's fire clearance does however not include any provision for bedridden residents. A type A citation is therefore issued on an attached LIC809-D for this deficiency. Bathrooms faucets and toilets are operational. Water temperature was verified to be within acceptable range. LPA observed emergency disaster plan with means of exiting and emergency phone numbers are listed and available for review by staff in a folder. Drills are conducted quarterly and documented. LPA observed the facility has a 2-day supply of perishables and a 7-day supply of non-perishable. Smoke and carbon monoxide detectors tested operational. Fire extinguisher present are fully charged with up-to-date maintenance tags.

There is adequately shaded outside space with outdoor furniture present. There is a self-latching gate on one side. The route of egress is free of obstructions. There are no bodies of water on the premises.