Facility Evaluation Report

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit to Springwell Haven. The purpose of today’s visit was to conduct the Annual Required inspection. LPA was allowed entry into the facility and explained the reason for the visit. Facility is licensed for 6 non-ambulatory residents. Facility has an approved hospice waiver for 3 residents and the home currently has 2 residents on hospice. Licensee Ramil De Los Santos and Administrator Cristy Valerio arrived during the visit. Upon entry, facility appears clean and sanitary.

LPA Lyman along with Caregiver Romeo Pegedped toured the facility at 8:50 AM. LPA toured the physical plant, checked food service, first aid kit and reviewed records. The home consists of five resident bedrooms, 2 common restrooms, 1 resident restroom, caregiver room, staff room, living room, dining room, and kitchen. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident rooms are single and double occupancy. LPA observed five residents with bed rails. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 115.8 and 118.8 degrees F in all facility restrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Common areas were clean and clear of hazards. First aid kit had all the elements including thermometer, tweezers and scissors. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Smoke detectors and carbon monoxide detectors tested operational during today's visit. Fire extinguishers are fully charged. Kitchen appliances are operational during today's visit. LPA toured the outside grounds and there is ample shaded seating for residents. Exit gates are unlocked and operational. LPA observed ample emergency food and water. Facility does not have documentation of required quarterly emergency drills. LPA reviewed the emergency disaster plan and infection control and plans are thorough and complete.