Facility Evaluation Report

On 03/11/2024 at 08:35 AM, Licensing Program Analyst (LPA) Melody Brown made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA Brown met with Staff #3 (S3) and was granted entry to the facility. At the time of the visit there were two (2) staff present, and six (6) residents present. Administrator Gabriel Torres -Thompson was contacted and informed of the visit. Facility Director Joaquin Thompson arrived during the visit. LPA Brown explained the purpose of the visit to Facility Director Joaquin Thompson.

The facility is a five (5) bedroom, four (4) bathroom home with a kitchen/dining area, living room, laundry room and detached garage. The facility is Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of six (6) residents of which four (4) can be ambulatory and two (2) non-ambulatory residents and one (1) may be bedridden resident. The facility has one (1) Hospice Waiver. The current census is six (6) residents. LPA Brown was accompanied by Staff #3 (S3) 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). LPA Brown observed no obstructions to indoor passageways but observed obstruction to outdoor passageways/area. LPA Brown observed glass window in the the backyard and a fire pit not used, metal chairs and metal table in disrepair. Deficiency will be issued.

The facility is maintained at a comfortable temperature of 76 degrees Fahrenheit. LPA Brown inspected resident bedrooms; they are equipped with required furniture such as: mattresses, lamps and storage space. However, LPA Brown observed insufficient lightning in Room #1 and S3 reported to LPA Brown that the light in Room #1’s not working and need to be replaced. Deficiency will be issued. Also, LPA Brown observed 2nd floor loft being utilized as bedrooms, three (3) beds observed and one (1) large sectional also being utilized as a bed. Deficiency will be issued. . ***Continuation in LIC809C ***