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25 | On 04/10/24 at 11AM, Licensing Program Analyst (LPA) D Panlilio conducted an unannounced required annual inspection. L PA met with Administrator (ADM) Yue 'Andy' Mou, and explained the purpose of the visit. ADM currently holds an administrator certificate (#6701195640) that expires on 08/30/25. The facility’s fire clearance was approved for six (6) non-ambulatory residents; all six (6) may be non-ambulatory and two (2) may be hospice.
At 11:20AM, LPA and ADM toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area, and outside yard area. The facility consists of six (6) bedrooms with adequate lighting for the comfort and safety of all residents. A sign-in policy, visitor’s logs, no touch thermometer, additional face masks and hand sanitizers were observed at the screening station. Emergency Disaster Plan, Complaint poster, Personal rights, Cough/sneeze etiquette, proper hand-washing signs were observed posted in common areas. Hot water temperature in the shared residents' bathrooms was measured at 115 deg F. Facility has a mitigation plan in place and the infection control leader is the administrator. Inside and outside pathways were free of obstruction and fire hazards. Smoke and Carbon monoxide detectors were operational. Fire extinguishers were observed fully charged and last inspected on 02/19/24. LPA reviewed 4 staff and 5 client files during visit.
No deficiencies observed during visit.
Updated copies of the following documents were collected for facility file:
LIC500- Personnel Report
Residents Roster
LIC308- Designation of Facility Responsibility
LIC610E- Emergency/Disaster Plan including infection control plans
Evidence of Liability Insurance
Exit interview conducted and a copy of this report provided. |