Facility Evaluation Report

Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced, required Annual Inspection. The facility file and personnel report was reviewed prior to the visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit to Caregiver Marilou Delapena. All staff present had criminal record clearances.

The facility's license shows a maximum capacity of six (6) non-ambulatory residents, one (1) of which may be bedridden. The facility is approved for four (4) hospice waivers. During today’s inspection there were four (4) residents in care, one resident was on hospice care.

LPA accompanied by Caregiver, toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Residents bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Hot water temperature at taps accessible to clients were all compliant:. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment (PPE). LPA observed staff to utilize PPE and perform hand hygiene when assisting residents.

The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility contained at least two (2) days of perishable food, and at least seven (7) days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. Knives were locked and inaccessible to residents in care.