Facility Evaluation Report

On 5/10/24 at approximately 10am Licensing Program Analyst (LPA) Maja Jensen arived at facility unannounced to conduct a required 1 year annual inspection. LPA Jensen met with Direct Service Provider/Co-Administrator, Nenita Indicio, and explained the purpose of today's visit. There are currently 3 ambulatory residents, none of which were present for this inspection.

LPA Jensen toured the grounds and observed them to be well maintained. All paths were free of obstruction. There are no bodies of water on the grounds. There is a shaded are with seating for outdoor activity. All window screens were observed to be in good repair. LPA Jensen toured the interior. The facility was observed to be sanitary and free of odor. Night lights are available in the hallway. Adequate lighting and furniture were observed. The Administrator holds a current Administrator's certificate good through 7/30/2025. The thermostat was set at 73 degrees Fahrenheit and is in compliance. The hallway bathroom water temperature was measured at 115.3 degrees Fahrenheit which is in compliance. All sharp objects, cleaning supplies and medications were locked and inaccessible to residents in care. The fire extinguisher was last serviced in February of 2024 and is in compliance. The carbon monoxide detector and smoke detector were tested and determined to be in good working order. There is emergency food, water and flashlights available. The first aid kit was observed to be complete. The emergency disaster plan was reviewed and determined to be compliant. The bedrooms were observed to have all required furniture. The facility maintains an adequate supply of linens. LPA Jensen inspected the kitchen and observed in excess of a two day supply of perishable food and a 7 day supply of non-perishable food. There was no expired food observed. The facility engages clients in activities such as Zumba dancing, bingo and playing cards. LPA Jensen observed trash cans without lids in the facility. Technical assistance was provided.

LPA Jensen requested and received a copy of the LIC 308, LIC 500, Surety Bond and Liability insurance, all of which were current and compliant. The staff on site had criminal background clearance and were verified as associated to the facility. LPA Jensen reviewed 2 of 2 staff files. Both staff have administrator certificates however both lacked HIV and TB training. Technical assistance was provided.