Facility Evaluation Report

Licensing Program Analyst (LPA) Christine Dolores arrived unannounced to conduct the facility's annual inspection. LPA met with Licensee, Dominica Oliva.

During visit, LPA toured the facility with staff to include the kitchen, dining room, resident bedrooms, staff bedrooms, bathrooms, and backyard. Fire exits are free and clear of obstruction. Facility temperature maintained between 69 - 76 degrees Fahrenheit.

Facility's kitchen observed in a sanitary condition. Facility maintains at least 2 days worth of perishable foods and 7 days worth of non-perishable foods. Refrigerator temperature maintained at 43 degrees Fahrenheit. Food stored in containers with lids and are labeled. Freezer temperature maintained at 0 degrees Fahrenheit. Chemical and sharp objects observed locked. Hand washing sign observed above the kitchen sink along with soap and paper towels.

Facility's backyard observed free and clear of obstruction. LPA observed at least 10 pieces of long wooden planks with exposed nails on the wood. During visit, the wooden planks of wood was removed from the premises.

LPA observed 6 out of 6 resident bedrooms equipped with proper furniture and supplies such as bedding, linens, adequate lighting, dressers, clothing, night stands, and a chair. Facility has an adequate amount of extra linens and towels to supply the residents. 1 out of 6 residents observed with a PRN of oxygen. Oxygen in use sign and facility emergency exit sketch observed posted on the door. LPA observed the physician's order for oxygen that was emailed to the Licensee. LPA advised to ensure the physician's order is maintained in the resident's file. Staff were provided training by a skilled professional on the oxygen equipment. SEE LIC812-C.