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25 | Licensing Program Analyst (LPA) Tao conducted an unannounced annual inspection visit. LPA met with Administrator. The facility is licensed to serve 6 non-ambulatory residents (age range from 60 years old and over), including 1 bedridden. Facility has hospice care waiver for 4 residents. Resident census is six (6). The annual fee is paid. LPA explained the purpose of today's visit and the inspection to the administrator.
During the visit, the following domain of the new inspection tool was used: infection control domain; a tour of the facility conducted; food supply was reviewed; Staff/Clients files were reviewed, and medications were reviewed.
The facility is a single-story home located in a residential neighborhood consist of 6 residents bedrooms, 2 bathrooms, a living room, a dining area, kitchen, laundry area in the garage, a garage, and an outdoor activity area at the backyard. The yard has a shaded area and free of debris/ hazard. Bathrooms are clean and operational. Sufficient supply of perishable and non-perishable foods. Adequate linen and personal hygiene supply. Smoke detectors are combined with carbon monoxide detectors and are operable and in compliance. The first aid kit is fully stocked with manual. The last Fire/ Emergency Drill was conducted on 3/25/2021. Medications are centrally stored, and locked. Hazardous items are locked and inaccessible to clients. Client and staff records have required documentation. Administrator certificate is current with expiration date on 06/02/2021.
Exit conference was conducted with administrator. LIC 809 was provided.
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