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25 | On 11/15/2024, Licensing Program Analyst (LPA) Pang Lee arrived at the facility to conduct an unannounced annual inspection. LPA met with Administrator Nnaemeka Ofodire. LPA Lee explained the purpose of today’s visit. Administrator Nnaemeka assisted with today’s inspection. Administrator Certificate # 6054572735 expires on 12/05/2025. The current census is 1 with 2 facility staff.
This facility is a single story building licensed to served four (4) ambulatory clients. LPA inspected the physical plant including but not limited to the common area, kitchen, dining area, client bedrooms, clients’ bathrooms, laundry room, staff room and outside courtyards of the facility to ensure compliance with Title 22 regulations. It was observed the facility was free of odor, clean and in good repair. LPA observed client bedrooms to be properly furnished with appropriate bedding and lighting. There are no bodies of water present.
LPA toured the kitchen and observed the facility had sufficient seven-day non-perishable food supplies and 2 days perishable food supplies. Hot water temperature was measured at 115.3 degrees Fahrenheit in client bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Smoke and carbon monoxide detectors are in compliance with fire safety. The fire extinguisher is located in the common area and was last serviced on 12/05/2025. The last fire drill was conducted on 10/23/2024. LPA observed the facility has a has a public telephone in the common area. Facility thermostat observed at 72 degrees Fahrenheit. LPA observed toxins located in the garage cabinet kept locked and inaccessible to clients. LPA observed sharp knives kept locked and inaccessible to clients. LPA checked medication storage and found medication to be locked away and inaccessible to clients. LPA reviewed and compared 1 out of 1 medication administration record (MAR) along with client medications and it was all complete. LPA asked to inspect the facility’s first aid kit and it was complete. LPA requested client and staff files for review. LPA reviewed 1 out of 1 client file and they were complete. LPA reviewed 2 staff files and they were also complete. LPA Lee reviewed staff criminal record clearances and a review of staff records indicates that all facility staff or other individuals who require caregiver background checks are fingerprint cleared and associated to the facility.
As a result of this annual visit, the facility is in compliance with Title 22 Regulation, and no deficiencies were cited. An exit interview was conducted, and a copy of these LIC 809 reports were provided to the facility.
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