Facility Evaluation Report

Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to the facility to conduct an annual required inspection. LPA Valerio was met by facility staff Luis, and explained the purpose of the visit. LPA was later met by Administrator Deane Jeffrey Dejaresco.

LPA Valerio observed two (2) staff on shift and six (6) residents in care. Staff were observed assisting residents with breakfast, morning ADLs, cleaning, and prompts to drink water. LPA Valerio observed the common areas of the facility to be fully furnished, clean, and free from hazardous items. LPA Valerio observed the kitchen area, where the sharps and medications were observed to be locked and inaccessible to residents in care. Residents bedrooms were clean and free from odors. Resident bathrooms were observed to be sanitary. Hot water was measured within the 105.0 - 120.0 degree F. The temperature inside the home was observed to be set at comfortable temperature. LPA Valerio observed the facility food supply. A technical advisory was given for the emergency food supply, as it was not enough for 6 residents and two staff members. The daily food supply was observed to be adequate. The garage was observed to be utilized for storage and have an area for staff breaks. The exterior area was observed. The facility replaced a section of the fence in the backyard.

LPA Valerio observed three (3) staff files and two (2) resident files. Resident files were observed to be up to date with required documentation. The administrator is waiting on R1's responsible party to sign the updated reappraisal and other updated documents. Staff files were observed to be complete with required annual training. LPA Valerio requested the following: LIC 500, LIC 308, LIC 309, LIC 610E, and Liability Insurance.

A Technical Advisory was issued today. No deficiencies were cited. An exit interview was held, and a copy of this report was provided to the administrator.