Facility Evaluation Report

On 12/21/23, Licensing Program Analysts (LPA) L. Salazar and LPA S. Doucette arrived to the facility unannounced to conduct the required Annual Inspection Visit. LPAs were greeted by Staff, stated the purpose of the visit and was allowed entry into the facility. Administrator arrived to the facility a few minutes later. Staff provided a tour of the facility inside and out. Administrator on record is Aida Pendon, Certificate #6013463735 Expires 04/2024. Administrator Rhonald Aranzaso's renewal certificate is pending.

LPAs observed 1 resident in care at the time of visit. Facility is a 5 bedroom / 3 bathroom home. Resident's have their own bedrooms and there are 4 live in staff. Resident rooms were observed to have the required lighting and furnishings and were free from odor and free from any passageway obstruction / fire hazards. Facility temperature was 70 degrees F.

Bathrooms were toured and observed to have operational lights, running water, and non- slip floors. Hot water temperature tested at 119.5 degrees F. Covered trash can with lid and hand washing postings were observed.

Medications were observed to be locked in a kitchen cabinet . Cleaning supplies were observed to be locked in the storage room in the garage. LPA toured the kitchen observed the required 7-day supply of non-perishable food and 2- day supply of fresh perishables to be properly stored. There are no residents with Restricted Health conditions in the facility.

Carbon monoxide and smoke detectors were tested and observed to be operational. Night lights were observed in the hallways. Fire Extinguisher was observed with a service date of 06/22/23. First aid kit was observed and contained all required items.

A sample of resident files were reviewed and observed to have update emergency contacts, Admission agreement, and current physician report/individual performance plans (IPP). A sample of P&I records were observed to be accurately logged and documented.