Facility Evaluation Report

On 09/26/2024 at 2:10 PM, Licensing Program Analyst (LPAs) Melody Brown and Becky Mann made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPAs Brown and Mann met with a staff and was granted entry to the facility. At the time of the visit there was one (1) staff present, and five (5) residents present. Licensee/Administrator Casimiro Jose was contacted and informed of the visit. Licensee/Administrator Jose arrived during the visit. LPAs Brown and Mann explained the purpose of the visit to Licensee/Administrator Jose.

The facility is a 4 bedroom, 2 bathroom home with a kitchen/dining area, living room, activity room and laundry area. The facility is Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of six (6) residents of which one (1) maybe bedridden. The facility has four (4) Hospice Waiver. The current census is five (5) residents. LPAs Brown and Mann was accompanied by Staff #2 (S2) to conduct a general overall inspection, which included, but was not limited to, the following:

Physical Plant : The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). LPAs Brown and Mann observed no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature of 70 degrees Fahrenheit. LPAs Brown and Mann inspected resident bedrooms; they are equipped with required furniture such as: mattresses, lamps and storage space. LPAs Brown and Mann observed sufficient lightning. Moreover, LPAs Brown and Mann observed that bathrooms were clean, and appliances were operating appropriately. LPAs Brown and Mann observed grab bars and non-skid mat in the resident bathrooms.

During the tour of the facility, LPAs observed the multiple cans of paints, chemicals and nails in the outside cabinet were not locked and accessible to residents in care. Deficiency will be issued.