Facility Evaluation Report

Licensing Program Analysts (LPAs) Simi Rai and Marcela Yanez conducted an unannounced case management visit to continue annual inspection from yesterday 8/28/2024. LPAs spoke with Licensee, Carlo Basilio over the phone and stated the purpose of today's visit. Licensee stated he could not be present at the facility due to scheduled appointment and Licensee gave verbal authorization for staff Leonida (Nida) Difuntorum to sign today's report on his behalf. LPA Rai observed 2 staff and 3 residents at the facility.

Fire extinguisher was last serviced on 9/27/2019. Per Licensee, new fire extinguisher was purchased but could not provide receipt during yesterday's visit (8/28/2024).

Facility smoke detectors and carbon monoxide detectors were in working condition. The last disaster drills which were conducted at the facility were not provided during today's visit. Per Licensee, staff are not aware where the disaster drill records are kept.

During yesterday's inspection, LPA Rai reviewed facility records for 2 staff (S1-S2) and 2 residents (R1-R2). LPA Rai observed 2 out of 2 staff files did not contain SOC341A Statement Acknowledging Requirement to Report Suspected Abuse of Dependent Adults and Elders. LPA Rai did not observe staff training provided for reporting suspected abuse of dependent adults and elders. LPA Rai observed 2 out of 2 resident files did not contain signed Personal Rights of Residents in All Facilities. LPA Rai observed 2 out of 2 resident files did not contain weight records where staff would measure resident's weight in pounds (lbs) or measurements of arms and/or thigh. LPA Rai observed 2 out of 3 resident files did not have signed Appraisal/Needs and Services Plan signed by resident and/or resident's responsible party.

During todays visit, LPAs reviewed facility file for R3. LPAs observed R3's facility file did not contain a Physician's Report.