Facility Evaluation Report

At approximately 1:30 PM, Licensing Program Analysts (LPAs) Julie Florio and Robert Frank arrived unannounced to conduct a required 1-year annual inspection and were greeted by Staff 1 (S1). Alma Corsiga, Licensee was contacted via telephone and arrived approximately 30 minutes later. Facility is a Residential Care Facility for the Elderly (RCFE) with four (4) residents in care. Three (3) residents were away from the facility either at Day Program or on a community outing and one (1) resident was present during today's inspection. Facility has a hospice waiver for two (2), with no hospice residents currently in care, and is approved for all non-ambulatory residents. Licensee informed LPAs that Administrator has changed to Angel Dean. LPAs informed Licensee of the need to submit this request to Licensing.

At approximately 2:00 PM, LPAs initiated a tour of the facility with Licensee and observed the following: Facility is a two story home, was a comfortable temperature, and passageways were free from obstructions. All residents live on the first floor of facility and Licensee's family lives on the second floor. Water temperatures in Residents' bathrooms measured within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPAs observed a supply of clean linens, paper products, and incontinent care briefs available to residents. Residents' bedrooms were inspected and observed to have appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. LPAs advised Licensee to ensure the laundry room remains locked at all times when unattended since there are chemicals and cleaning supplies in the room. Facility has at least two days of perishable food and LPAs advised Licensee to increase the facility's supply of non-perishable foods to ensure facility can sustain all residents in care for 7 days in the event of an emergency. Additionally, LPAs observed at least five (5) instances of expired non-perishable foods, (see LIC809D). Medications were centrally stored and locked. There is a covered seating area in the backyard with outdoor space for activities. LPAs observed the fence in the backyard on the left side of the facility to be damaged and falling down, (see LIC809D). LPAs advised Licensee to ensure the facility has a designated internet access device available for resident use to remain in compliance with regulation. Facility has internet available to residents in care and the phone was tested an operational.