Facility Evaluation Report

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced, required Annual Inspection. The facility file and personnel report was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to Caregiver Mila Flotildes and Licensee Gus Fernandez. The facility's license shows a maximum capacity of six (6) non-ambulatory residents, one (1) of which may be bedridden. Bedridden resident may reside in bedroom #1 only. Additionally, the facility is approved for two (2) hospice waivers. During today’s inspection there were six (6) residents in care.

LPA and Licensee Fernandez 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. Client 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: Common bathroom sink in hall restroom was 107.2F and common bathroom sink in the restroom adjacent to the garage measured at 115.7F. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment.

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. As LPA was shown the drawer where knives are stored, LPA noted that the lock mechanism was broken, rendering the drawer accessible to residents in care. Staff immediately moved the knives in the drawer to a locked storage room. As a staff member was present and working in the kitchen from when LPA arrived to when the broken lock was noted, a Type B citation was issued as opposed to a Type A for the accessible knives.