Facility Evaluation Report

Licensing Program Analyst (LPA) Dang Nguyen made an unannounced visit to conduct a Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified himself to, and discussed the purpose of the visit with Caregiver Alba Bencomo. LPA then met with Licensee Vanessa Nunez and Administrator Karina Lopez, who arrived shortly after.

According to the facility’s license, the facility has a maximum capacity of six (6) residents, of whom all may be ambulatory or non-ambulatory, but none may be bedridden. According to LIC602 Physician’s Reports, staff interviews, and LPA observation: During this annual inspection, there were a total of six (6) residents in care, of whom all were non-ambulatory, per their respective doctors. The facility’s license did not include endorsements for delayed-egress doors or secured perimeter, and neither of these were present.

During this inspection, LPA interviewed multiple staff, observed multiple residents, toured the interior and exterior of the facility, inspected all common areas and bedrooms. LPA also reviewed the care records for all residents and the personnel and training files for all current staff.

The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows and screens, toilets, and showers were working. Extra linens, hygiene, and Personal Protective Equipment (PPE) supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities.