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 Ryker Heberle (LPA) conducted an unannounced annual inspection on 03/23/2023 at 12:10pm. LPA met with facility Administrator Lusanta Kaiyom (Admin).
LPA toured the facility, including living room, kitchen, dining room, laundry room, 10 bedrooms, 5 bathrooms, medicine room, back patio. Admin confirmed that all staff and residents have been vaccinated with booster shots.
Facility Mitigation plan has already been submitted. No prohibited items noted in resident rooms. 2 emergency exit gates located on back patio were observed to be obstructed by broken furniture and pile of wood. All rooms in facility noted to be clean and well maintained. Facility water temperature measured between 105.1*F and 116.9*F. Hand sanitizers, soap, and paper supplies were observed to be available. At least 2 days' supply of perishable food and at least 1 week's supply of non-perishable food was observed on the premises. Fire extinguisher observed to be inspected in March 2022. Smoke/carbon monoxide detectors tested and observed to be operational.
LPA interviewed 10 facility residents and 6 facility staff. 10 out of 10 residents interviewed claimed to be satisfied with facility services. 6 out 6 staff interviewed demonstrated understanding of position duties. All staff members present at the facility were observed to be fingerprint cleared on Guardian. LPA reviewed 10 resident files, 1 out of 10 resident files did not have a signed admissions agreement. All other necessary documentation observed. LPA reviewed 6 staff files. 6 out of 6 staff files did not contain complete information on staff training. Facility disaster plan and plan of operation were observed to be complete and reviewed within a year's time.
Deficiencies cited during today's visit. This report was reviewed with Administrator Lusanta Kaiyom and a copy of the signed report was provided via email due to printer error. |