Facility Evaluation Report

Licensing Program Analyst (LPA) Valeria Conway arrived at the facility unannounced to conduct a continuation of the required annual visit at 10:50 A.M. LPA met with caregiver Calixto “Alex” Calixtro and discussed the reason for the visit. Licensee, Maricar Lee, was contacted via telephone. Licensee arrived at 11:15 A.M. Administrator, Michelle Parr, joined the visit shortly after. Entrance interview conducted.

Physical plant tour was conducted during the Annual visit. Today, a brief tour was conducted. No health and safety concerns were identified during today's tour.

Today, LPA will conduct a medication and files review; the following was observed:

RECORD REVIEW: Between 11:20 A.M. and 1:30 P.M., staff and resident records were reviewed for documents including, but not limited to: health screening, TB test, staff training records, fingerprint clearance, resident physician's report, needs and service appraisal, and personal rights. 6 (six) resident records reviewed were complete and contained all required documents. Six (6) staff files reviewed were complete and contained all required documents.

MEDICATION REVIEW: Began at 1:45 P.M. Medications for six (6) residents were observed. All medications are centrally stored in a locked closet at the end of the hallway between room #1 and room #5. Prescribed medications including PRN were labeled, stored, and inaccessible to residents in care. LPA observed discrepancies on the Centrally Store Medication and Destruction Log for two (2) residents.