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25 | At 10:30am, Licensing Program Analyst (LPA), Angela Panushkina, Regional Manager (RM), Angela Wittaker, Licensing Program Manager (LPM), Nichelle Gillyard along with the Fire Inspector, Linsay Pellegrini conducted a Case Management visit. The team met with the Executive Director, Amanda Monroy, and explained the reason for the visit.
LPA requested resident and staff roster. The facility currently has approximately thirty seven (37) non-ambulatory residents residing on a second floor. During the 10/10/24 visit, LPA informed the facility that this is a Health and Safety issue and requested to provide a Written Plan within 48-hours. However, during today's visit, a second request was made for the facility to submit a written plan. The team was informed that the facility continues to conduct routine checks on non-ambulatory residents every two (2) to four (4) hours. Executive Director will submit the Written Plan to LPA within 24-hours. In addition, Executive Director was provided a copy of the occupancy certificate, issued by Building and Safety, which indicates "No Non-Ambulatory" residents on a second floor.
At approximately 11:00am, LPA, LPM, RM and the Fire Inspector conducted a physical plant tour, to ensure health and safety of the residents are protected and physical plant is in compliance with Title 22 Regulations. Fire Inspector recommended a search protector to be used for all decoration cords. A chair in a hallway, by the room #120, blocked the clearance and the Fire Inspector requested the chair to be removed/relocated. At 11:30am, the team went up the stairwell to inspect the roof access. Executive Director informed the team that once the door opened, each employee receives a notification on their pagers for an immediate assistance. The Fire Inspector recommended an auditory alarm also to be placed on all "roof access" doors for an extra safety. It was observed that Maintenance storage door and housekeeping carts which stored chemicals were unlocked and upon request the Executive Director immediately locked and removed all chemicals. The team requested an additional training/meeting to be provided to all staff.
No deficiency issued during todays visit.
Exit interview conducted and copy of this report signed and delivered. |