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) Celine De Perio conducted an unannounced required annual inspection focusing primarily on the Infection Control. LPA De Perio explained reason for visit and was greeted and granted entry by staff on duty who checked temperature prior to entering facility. During the visit, 2 staff were on duty, one of which was facility administrator (AD) Richard Mendoza Jr. As of 10/24/22, there are 0 active COVID-19 cases in the facility as verified. LPA De Perio observed the COVID-19 precautionary signs posted in the living room. The PUB475 "See Something, Say Something" poster was also observed in the hallway of the facility. LPA observed the Administrator's Certificate for Richard Mendoza which expired on 6/12/2022, however, AD Mendoza provided LPA De Perio proof of renewal payment and email that certificate is pending and in process.
LPA De Perio toured the interior and exterior portions of the facility with AD Mendoza. The facility is a single level structure and is licensed for residents 60 years and over, of which 5 may be non-ambulatory, 1 bedridden and a hospice waiver for 2, of which was approved on 9/18/2012. For this visit, there are a total of 4 residents in care, of which 0 are on hospice and 0 bedridden. There are a total of 6 bedrooms, of which 4 are private resident rooms, and 1 is shared among residents and 1 is for staff use. LPA De Perio toured each bedroom in the facility and observed that bedrooms were provided with furniture in good repair, clean linens, adequate storage space, and kept free of tripping hazards. Smoke and carbon monoxide detector and auditory exit alarms were tested and operational. There are a total of 2 restrooms of which were observed to be in good repair, toilets were operational, and grab bars and non-skid floor mats were provided. Water temperature in restrooms were measured to be at 120.0 degrees Fahrenheit and hand washing signs were also posted in each restroom. |