Facility Evaluation Report

On 11/21/2023 at 08:32 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 Administrator Russell Bernardo, was granted entry to the facility. At the time of the visit there were two (2) staff present, and six (6) residents present. Licensee/Administrator Evafe Green – Sosnovsky was contacted and arrived during the visit.

The facility is a five (5) bedroom, three (3) bathroom home with a kitchen/dining area, living room. The facility is Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of six (6) non-ambulatory residents and one (1) may be bedridden and with approved hospice waiver for six (6). The current census is six (6) residents. LPA Brown was accompanied by Administrator Bernardo 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 (CCL). LPA Brown observed obstructions to outdoor passageways as the backyard was observed with unused grills, ladder, tables, chairs. Deficiency will be issued. In addition, LPA Brown observed cleaning supplies not locked in the laundry room and are accessible to residents in care. Deficiency will be issued as this pose immediate health, safety and personal rights risks to residents in care. The facility is maintained at a comfortable temperature. LPA Brown inspected resident bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA Brown observed no non-skid mat or strips in the hallway bathroom. Deficiency will be issued. Also, the cleaning supplies storage cabinet lock was broken or in disrepair located in the laundry room making it accessible to residents in care. Furthermore, LPA Brown observed pre-poured residents medication for the whole day, not locked in the kitchen drawer. Deficiency will be issued.