Facility Evaluation Report

ON 05/14/2024, Licensing Program Analyst (LPA) L. Salazar conducted a second Pre-licensing visit. LPA was greeted by Administrator and was granted entry into the facility. LPA conducted the inspection with Administrator using the Inspection Tool. A tour inside and outside the facility was conducted.Comp III was reviewed, and the following regulations were discussed:

Persons providing night supervision (10 p.m. to 6 a.m.) for RCFE must be available to assist in caring for residents as required. Staff must be awake for dementia diagnosed residents.

Licensee should conduct a pre-appraisal for each resident prior to resident’s admission into the facility.

The appraisal for each resident must be kept on file

Acceptance and Retention limitations:87455

Patients requiring 24hour, skilled nursing or immediate care in a health facility will not be accepted.

Licensee cannot accept persons who require inpatient care in a health facility or skilled nursing facility or depend on others to perform all activities of daily living.

Licensee cannot accept persons with conditions listed: Stage 3and 4 pressure injuries; gastrostomy tubes; naso-gastic tubes; tracheostomies; staph of other serious infection.

Menus must be written at least one week in advance.

Copies of menus are served as dated and kept on file for 30 days.

Modified Diets as prescribed by a person in care’s physician must be provided to that person in care.

Licensee must provide planned activities, group interaction, social activities, physical activities.

Administrator will notify licensing and send LIC 9020 (Resident roster) when first resident is accepted. Comp III completed.