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 (LPA), Shobhana Frank , made an unannounced visit to the facility to conduct a required - 1 Year inspection. LPA Frank was granted entry into the facility by Licensee Teresita Lozano. LPA Frank reviewed the facility file, reviewed Mitigation plan – LIC 808 –Mitigation Plan prior to visit. LPA complete Facility Risk Assessment prior to the visit.
A tour of the facility was conducted inside and out of physical plant.
Two staff and three residents were present at the time of inspection. Facility has a capacity of six (6) residents, ages sixty (60) and above. The facility is operating in the capacity and conditions approved by CCL.
Facility is a single story structure which has the capacity of retaining 6 residents. This facility has 6 bedrooms and 3.5 bathroom, 5 private bedrooms and 1 staff bedroom. LPA observed COVID - 19 station equipped with hand sanitizer, thermometer, Gloves, visitors log. LPA observed COVID- 19 posters throughout the facility. LPA observe the facility to be clean and in good repair. Physical Plant and Safety of Environment/Operational Requirements.
The home is maintained at a comfortable temperature for the residents. Lighting is sufficient for safety and comfort. Water temperature measured 108.9 degrees F. Grab bars, non-slip mats are present in the restrooms. Laundry facilities and a locked cabinet is present for storing laundry soap, Sufficient PPE supplies and other chemicals in the garage.
On 6/23/21 facility conducted surveillance Testing and results are negative.
Resident Records/Incident Reports/Personal Rights/Residents with Special Needs/Incidental Medical and Dental- LPA reviewed two staff file two resident file, two clients interviews were conducted. facility is meeting documentation requirements. Resident Rights are posted in the facility and a copy is signed on file. Dementia and hospice regulation requirements are being met. |