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25 | Licensing Program Analyst (LPA) Alviso conducted a Required- 1 Year visit, on 4/18/23 at approximately 3:00pm, and met with Administrator/Licensee Catherine (Cathy) Clark. Currently there are five(5) residents in care.
Facility has an approved dementia plan of operation. There is an approved hospice waiver for one(1) resident. Facility submitted the required infection control plan. Fire clearance is approved for six (6) non-ambulatory, which includes one(1) bedridden, The bedridden is cleared for resident room #3, Al exits were free and clear of obstruction. Fire extinguisher was charged, and with receipt of purchase on 2/28/23. LPA observed six(6) of six(6) smoke alarms, that are also carbon monoxide detectors, all were working properly during the inspection.
Administrator stated the home owner has completed the requirements by the Planning Department, to break down and remove the staff/office room that was built without permits, LPA observed the garage is now back to being a one(1) car garage as required. The LPA will request a fire clearance re-inspection which will update records, and also comply with the fire departments request of re-inspection when changes were complete.
Administrator will submit an updated sketch to show the changes that have been completed, removal of staff/office room, and changes in resident capacity; Room three(3) is the only shared resident room, and the other three(3) resident rooms are all private resident rooms. Administrator stated that five resident capacity is what the sketch will now show. Administrator to submit, no later than 5/2/23, an updated facility sketch LIC999, and an updated application form LIC200.
LPA reviewed Infection Control Plan requirements with the Administrator. This Required 1-Year visit will be continued at a later date. |