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 Hermelinda Perez was notified of the visit via telephone and arrived shortly afterwards to assist with the visit.

There are currently five residents in care, three of which are currently receiving hospice care after one resident alternated from her admission into palliative 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 two-story house with an attached garage. The second level is for use by the licensee and their family exclusively, with all family members over 18 shown to be background cleared. The facility has one private bedroom and two shared rooms . There are two full bathrooms throughout the facility, one designated for use by residents and the other one for staff, visitors and third-party providers.

Bedrooms appeared clean and sanitary. Two beds are equipped with full rails and one bed with half rails. Physician orders and hospice plans of care for all postural supports in use reviewed. LPA observed all the resident bedrooms have the required furnishings. Bathrooms appear clean and sanitary. Bathroom are equipped with grab bars and slip mats. Hot water temperature measured at 113.2F in the bathroom used by residents.

LPA observed the kitchen has a minimum two (2) day perishable and seven (7) day non-perishable food supply. Sharp items are stored in a secure drawer. Fire extinguisher is charged and mounted, with up-to-date maintenance documented on an attached receipt. LPA tested the smoke and carbon monoxide detectors which were found to be operational. The centrally stored medication is located in a secure closet located in the dining area. The attached garage is inaccessible to residents and is used for storage and laundry, with an additional refrigerator/freezer present. Cleaning supplies are stored securely in the garage.