Facility Evaluation Report

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced required Annual Inspection. The facility file was reviewed prior to the visit. LPA Lopez identified herself, was granted entry by caregiver Teofila Mayo. LPA discussed the purpose of the visit with Administrator Vanessa Sanchez. Licensee Angelita Sanchez later arrived and joined the visit.

According to the facility’s license, there may be a maximum of five (5) residents, four (4) of whom may be non-ambulatory in rooms 1, 2, and 4 in at any given time at the facility site. The facility is approved for a wheelchair in room #4 and 1 hospice is approved. During today’s inspection, the facility’s current census is two (2) residents living at the facility. There were 2 residents present at the facility site during the inspection.

LPA, accompanied by caregiver Erminda Aquino, toured the interior and exterior of the facility, and inspected each room. The facility was clean and in good repair. There was an insect found during the inspection. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. 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 activities.

The facility’s ambient internal temperature was comfortable and compliant, at 73 degrees F. Hot water temperature at taps accessible to residents read as follows: kitchen sink initially measured hot water at 135 degrees F but later measured 111 degrees F; sink in restroom #1 delivered hot water at 120 degrees F; sink in restroom #2 initially delivered hot water at 136 degrees F, but later measured at 113.5 degrees F; and sink in restroom #3 initially measured hot water at 137.7 degrees F, but later measured at 111.6 degrees F. The hot water temperatures were lowered during the inspection and were cleared.