Facility Evaluation Report

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual and met with Alex Molitvenik, Administrator. The facility is licensed for (6) non-ambulatory residents and has a hospice waiver for (4) residents. (1) resident was watching television in the common area and (4) residents were resting in their rooms at the start of the inspection. There are (0) residents receiving hospice care.

LPA and the Administrator toured the interior/exterior of the facility including common areas, (4) private resident bedrooms, (1) shared resident bedroom, (3) resident bathrooms, kitchen, office, staff and laundry area. LPA observed the facility to be clean, in good repair and odor-free. Bathrooms have the necessary grab bars, non-skid flooring, and hand-washing posters. LPA discussed how individual cloth towels must be used if multiple residents are using the bathroom. There is sufficient 2+day perishable supply of food and 7+day non-perishable supply of food. Sharps and toxins were locked in the kitchen and additional toxins are secured in the laundry area. Medications are secured. There are sufficient linens, blankets, and the First Aid kit contains scissors, tweezers, bandages and a thermometer. A new kit will be purchased containing ointments. The hot water measured 118*F in the kitchen. Inside temperature measured 74*F. The smoke/monoxide alarms are working, and all exit doors have a signal device. There are (2) unlocked exits, with signal alerts, in the backyard, and outdoor space with seating. All required postings are visible in the common area. LPA reviewed (2) resident files and (2) staff files- Files were organized and contained current paperwork. Medications/orders reviewed for (1) resident- no discrepancies noted. Staff is cleared/associated and has current First Aid/CPR and other required training. Updated insurance information obtained. Plan of Ops to be updated with updated Dementia regs (1/25). Administrator RCFE Cert # 7007506740 (exp 1/18/27). |There were no deficiencies observed.

Exit interview. Copy of report provided to the Administrator