1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25 | Licensing Program Analyst(s)(LPA) Mary Flores and Christian Gutierrez conducted an unannounced annual visit at the facility using the inspection CARE tool. LPAs met with Lourdes Sandoval caregiver and explained the reason for the visit.
Facility is licensed to serve 6 non-ambulatory residents over the age of 60, of which (6) may be bedridden, and has a hospice waiver for (6). The facility is a single home in a residential area and consist of a kitchen, a living/dining room, with 6 resident rooms, 2 bathrooms, a laundry area, a detached garage, a front yard, and a back yard.
LPAs conducted a tour with Lourdes Sandoval and observed the following:
Facility is in good repair indoor and outdoor. Living/dining room has furniture and in good repair. Kitchen is clean, in good repair, and sufficient food was observed for at least 2 day of perishables and 7 days of non-perishables. Cleaning supplies and medication was observed locked in the kitchen. Each resident room (6) has sufficient lighting, furniture, and bedding supplies. Each bathroom (2) is clean, in good repair, and water temperature was tested between 109.2 -115.1 degrees F. which is within the required 105-120 degrees F. Laundry room was observed in good repair. Carbon Monoxide/Smoke detectors were observed and tested. Additional supplies are stored in the garage and shed. Garage provides a rest area for staff. Backyard and front yard are clean and provide shaded sitting area. No large bodies of water were observed.
LPAs reviewed files and medication for 5 residents, and 5 staff files. Emergency Disaster plan and Infection control plan were reviewed. Last fire drill was conducted on 1/8/24. Administrator certificate was observed for Nvard Gevorkian #605043740 exp. 12/23/24.
No deficiencies were noted during this visit.
Exit interview was conducted with Nvard Gevorkian and a copy of this report was provided. |