Facility Evaluation Report

On 7/11/2023, Licensing Program Analyst (LPA) Tung Truong arrived at this facility unannounced to conduct an annual inspection visit. LPA met with Administrator Iheoma Nwangburuka and explained the purpose of the visit.

Administrator holds certification #6035025740 and is expired on 4/6/2023. Renewal application has been submitted and currently pending. The facility is licensed for 6 non-ambulatory residents. Approved hospice waiver for 1. There are currently 5 residents who reside in the facility and 1 resident who is currently at a skilled nursing facility.

LPA toured and inspected the physical plant inside and outside to ensure there are no safety hazards to residents in care. LPA observed required furniture and lighting throughout the facility. LPA observed supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days maintained on the premises.

The hot water temperature was measured at 113.5*F which was within the required range of 105-120*F. The temperature inside the facility measured at 78*F which was within the required range of 68-85*F.

LPA observed the centrally stored medications area to be locked and inaccessible to residents. LPA observed the fire extinguisher(s) and first aid kits were up to date. LPA observed smoke and carbon monoxide detector(s) in the facility were in good repair. Proof of current liability insurance was observed.

LPA requested resident and staff files for review. LPA reviewed (6) resident files and (2) staff files, including criminal record clearances. LPA reviewed staff associations to the facility. A full Care Tool Inspection was completed at facility.