Facility Evaluation Report

On December 27, 2024, at 8:40 AM, Licensing Program Analyst (LPA) Kiran Jain arrived unannounced at the facility to conduct a Required 1-Year Annual inspection. LPA met with DSP, Wilma Bacuno and disclosed the purpose of the inspection. The Administrator, Orlando Ferrer joined shortly after. The administrator informed the LPA that the facility currently has (3) staff members and (3) residents in care, 3 of residents are ambulatory. (2) Residents were away for vacation with their families and (1) resident was away at the day program.

At 8:46 AM, the LPA initiated a walk-through of the facility, accompanied by the DSP.

There are (3) bedrooms and (2) bathroom designated for residents' use. (2) resident bedrooms are private and (1) resident bedroom is shared occupancy. (1) Resident bedroom had a private bathroom. LPA inspected all (3) resident rooms and found them clean, well-lit, and equipped with the required furniture.

At 8:58 AM, LPA inspected the resident’s private bathroom in shared occupancy room and observed Lysol Disinfectant spray bottles, comet bleach under the sink cabinet unlocked and accessible to the residents. LPA observed the bathroom clean, sanitary, and in good working condition. It contained soap, grab bars, a trash can, non-slip mat and flooring. The hot water temperature at the sink faucet was measured at 113.5°F. LPA inspected the common bathroom and observed Clorox bleach, Comet bleach, Lysol cleaning solutions under the sink cabinet unlocked and accessible to the residents. This bathroom contained soap, grab bars, a trash can, shower tub with curtain, and a non-slip shower mat. The hot water temperature at the sink faucet was measured at 114.6°F. The Administrator removed all the Disinfectant, bleach and cleaning solutions from both the bathrooms and placed them in a locked cabinet in the laundry area.

LPA inspected the kitchen and found it clean, with no food preparation or cooking in progress at the time. LPA checked the appliances and observed them in working order. The locked cabinet containing knives and the locked cabinet under the sink with soap and cleaning supplies were also inspected. LPA inspected the refrigerator and pantry cabinets and observed enough supplies of fresh perishable food for (2) days and nonperishable staples for (7) days. No expired food and no stored medications were noticed.