Facility Evaluation Report

Licensing Program Analysts (LPA) Emily Peraldi arrived at the facility unannounced to conduct a required annual visit. At 9:35 a.m., the LPA met with staff and explained the reason for it visit. At 9:55 a.m., the Licensee, Rodolfo Ohide arrived at the facility.

RECORD REVIEW: Between 10:04 a.m. and 12:00 p.m., the LPA conducted a file review for all four (4) residents and staff regularly scheduled and observed the following: Resident records were reviewed for, but not limited to care plans, medical records, admissions agreement, consent forms. Two (2) out of four (4) residents did not have a physician’s report/ medical assessments. One (1) out of four (4) residents require updated appraisals/needs and service plan, a technical violation was issued. Three (3) out of four (4) residents require a preadmission appraisal, a technical violation was issued. Administrator’s Certificate is pending for renewal. The LPA could not identify staff records, including training records, a technical violation was issued. The LPA had several conversations with the Licensee with the goal of providing education in regard to maintaining current resident and staff records.

At 1:14 p.m., the LPA, along with the Licensee toured the physical plant areas inside and outside to ensure there are no health and safety hazards.

KITCHEN: The LPA observed the kitchen and dining area. Knives are stored in a locked kitchen cabinet. Kitchen appliances are in operable condition. The facility has a sufficient supply of perishable and non-perishable food. At 1:17 p.m., hot water measured at 107.4-degree Fahrenheit.