Facility Evaluation Report

At 11:06AM Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct a required annual visit. The LPA was greeted by staff Willfredo Macandili and informed them of the reason for the visit. Administrator Maria Macandili arrived at 11:25AM. Entrance interview conducted.

At 11:40AM, the LPA, along with Administrator, conducted a tour of the physical plant to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. The following was observed:

Facility fire extinguisher was fully charged and recently purchased on 09/22/2023 . All hardwired smoke alarms were tested at 01:57PM and carbon monoxide detectors were tested at 02:10PM and all functioned properly. The LPA observed all required postings throughout the facility.

Bathrooms: The facility contains 3 (three) bathrooms. Administrator indicated 1 (one) is for resident use and 2 (two) are for staff use . LPA observed the resident bathroom, which was properly supplied and had functional fixtures. The LPA observed grab bars and non-skid mats. The hot water was measured in the shared bathroom during the physical plant tour. Hot water measured at 116.0 degrees Fahrenheit, which is within the required range.

Bedrooms: The facility contains 6 (six) total bedrooms ; 4 (four) a re designated for resident use and 2 (two) are designated for staff use. Th e resident bedrooms were properly furnished and sufficient lighting. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets. S t aff rooms were observed to be locked. Resident #1 (R1) was observed to have full bedrails. Administrator indicated that R1 had been on hospice and staff stated they had requested half rails for R1 from the vendor, but had yet to receive them.

Kitchen : The kitchen appeared clean and the appliances and fixtures functional. The LPA observed a sufficient amount of perishable and non-perishable food at the facility; Sharp objects are stored in a locked cabinet. Report continued on LIC 809-C