Facility Evaluation Report

Licensing Program Analyst (LPA) Martha Arroyo arrived at the facility unannounced to conduct a required annual visit at 8:45 a.m. This annual has a specific emphasis on infection control practices and procedures. The last annual conducted at this facility was on 04/18/2019. Upon entering the facility, the LPA observed four (4) staff not wearing masks. The Administrator, Inga Jakobovich arrived at 9:25 a.m. and was explained the reason for today's visit. Entrance interview conducted.

At 9:30 a.m., the LPA and Administrator began a physical plant tour to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations.

The facility's dining room and kitchen were observed. LPA observed facility had a sufficient supply of perishable and non-perishable food and food was stored at appropriate temperatures. All knives and sharps are locked inaccessible to residents. A random selection of four (4) resident bedrooms were observed. The LPA observed the resident bedrooms, which were furnished appropriately. Observed inside each room was a bed with clean linens, a nightstand, and sufficient lighting. The LPA observed the restrooms to be clean, sanitary and in operating condition with grab bars and non-skid mats inside the shower. The water temperature was tested on each of the three floor levels. Level one bathroom measured 116.6 degrees Fahrenheit, second level bathrooms measured at 100 degrees Fahrenheit and 104 degrees Fahrenheit, and third level bathroom measured 105.8 degrees Fahrenheit. Fire extinguishers observed were fully charged and last serviced on 11/21/2021. At 9:59 a.m., the LPA observed the medication room, the door does not lock making all medication accessible to residents in care. The Administrator called the maintenance worker to have fixed at the time of visit.