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 | On 06/14/2024 Licensing Program Analyst (LPA) Avelina Martinez made an unannounced visit to this facility to conduct an annual required inspection. LPA Martinez met with Juanito De La Cruz and Arlyn De La Cruz and explained the purpose of the visit.
LPA Martinez inspected the physical plant including but not limited to the kitchen, dining room, resident bedrooms; resident bathrooms, laundry room, activity room, and outside courtyards of the facility to ensure compliance with Title 22 regulations.
The facility is licensed for six ambulatory resident, which two may be non-ambulatory and reside in bedroom two. There are currently 4 residents who reside at this facility.
LPA Martinez toured the facility with Juanito De La Cruz and Arlyn De La Cruz on 06/14/2024 at 1:00 PM.
LPA Martinez reviewed two staff files and four resident files, which were maintained. The facility has a natural disaster plan, and the last fire drill was on June 08, 2024. The facility has the required postings throughout the facility. LPA Martinez reviewed 4 medication administration records (MARs), which were maintained. LPA Martinez requested medication orders for Client 1 Omega-3 1,000 MG. LPA Martinez requested client's 2 stool softener 100 MG medication order. Orders should be emailed to LPA Martinez by June 21, 2024 5:00 PM. LPA Martinez requested a copy of the Infection Control Plan- LIC 9282 and liability insurance The Administrator agreed to email the requested documents to LPA Martinez by June 21, 2024 5:00 PM. Fire extinguisher, smoke detectors, and carbon detectors were in good repair. The water temperature measured at 110 degrees and facility temperature measured at 70 degrees. The facility had an adequate food supply, and all toxins were stored in a locked cabinet.
Based on this annual inspection, there were no deficiencies cited. An exit interview was conducted, and a copy of this report was provided to the facility.
|