MEDICATIONS

LPA observed a black, metal, centrally located medication/file storage cabinet with a locking mechanism in the combined kitchen and living area of the facility.

PHYSICAL PLANT

The interior facility is clean, sanitary, and in good repair. Protective devices are in place to include nonslip material on rugs. Facility temperature was 70 degrees at the time of inspection. Outdoor areas of potential hazard are well-lit. Fire Alarms and Smoke alarms tested and operated properly. Carbon monoxide detectors operate properly. Locked cabinet for sharps and chemicals were observed in the facility. There is an outdoor activity space with a shaded area and furnished for outdoor use a brand-new shaded canopy in the facility.

Please see (LIC809-C) for report continuation.

• Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

• Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

Halls, garages, storage areas, and sheds, or similar detached buildings are not being used as client bedrooms. Client bedrooms are large enough to allow for easy passage and to accommodate furniture and assistive devices such as wheelchairs, walkers. No client bedroom is a passageway to another room, bath or toilet. There is a bed for each client with a mattress, mattress pad, bedsprings, and pillow(s) which are clean and in good repair. Mattresses and pillows are flame-retardant. There are dresser and closet space for each client that includes at least two (2) drawers or eight (8) cubic feet of dresser space per client. There are chairs and lamps for each client and (1) nightstands for clients. If applicable, resident bedrooms with security bars on windows/doors have at least one (1) window/door in the bedroom with an approved safety release to allow emergency evacuation.

BATHROOMS

There are (2) toilet and (2) washbasin per six (6) residents, family, and personnel. There are (2) showers or for residents, family, and personnel. At the time of inspection, hot water was tested in bathroom and read 115 degrees F. Bathrooms are located near client bedrooms. There are night-lights in the hallways outside non-private bathrooms.

SUPPLIES

There are personal hygiene supplies to include, soap, toothpaste, toilet paper, and comb. There is a sufficient supply of clean linens to permit weekly changing or more of resident top sheets, bottom sheets, bedspreads, blankets, pillowcases, mattress covers, bath towels, hand towels, and washcloths.

FOOD SERVICE

Dining room is near kitchen. Refrigerator(s) and freezer(s) are clean and large enough for the storage of at least two (2) days of perishable foods. A seven (7) day supply of non-perishable food is present. The kitchen, all equipment, dishes, utensils, food storage, and preparation areas are clean are in good repair.

Please see (LIC809-C) for report continuation.

There is confidential storage of personnel & resident records at the facility.

ADMINISTRATION

The emergency exiting plan and emergency phone numbers, Personal Rights, Visiting Policy, Licensing Complaint Poster, Resident council meetings and resident council are not posted.

ACTIVITIES

There is at least one common room available to clients for visitors. There are activity supplies to include newspapers, Board & Card games, magazines, and a variety of reading materials.

MISCELLANEOUS

There are first-aid supplies to include sterile first-aid dressings, bandages, adhesive tapes, scissors, tweezers, thermometer, antiseptic solution, and a current first-aid manual. There are space and equipment for laundry. There is a space for clean linen storage and a separate space for soiled linen. There is an operating cellphone available to clients. Emergency lighting and supplies to include flashlights with batteries.

PRE-LICENSING CHECKLIST: Completed by licensee and reviewed by LPA.

COMPONENT III: Provided information about how to operate the facility within substantial compliance.

TECHNICAL ASSISTANCE: During the continuation pre-licensing inspection, the following items were observed which did not comply with applicable laws and regulations; the following items must be corrected and require a follow-up inspection for verification of correction.

1. During the continuation pre-licensing inspection, Bathroom #1 and Bathroom #2 were observed to lack grab bars adjacent to the toilet and bathing areas, limiting residents’ ability to safely stabilize themselves during use of the restroom and bathing facilities.

Please see (LIC809-C) for report continuation.

3. The exterior of the facility was observed to be in disrepair and not free from hazards. Specifically, on the side exterior of the facility, a large accumulation of cardboard boxes stacked approximately five (5) feet in height and extending approximately fifteen (15) feet in length was observed, with loose trash present in the same area.

4. At the rear exterior of the facility, the garage was enclosed only by a thin mesh covering and contained a vehicle, wood planks, multiple containers and boxes and did not have a solid physical door to restrict access.

5. Behind the garage an open space measuring approximately two (2) feet in width and extending approximately fifteen (15) feet in length a brown metal bed spring in a rusted condition, loose trash, and an old mattress.

6. A fruit tree, appeared to be a lemon tree, was observed in the rear exterior area; the tree was overgrown, not maintained, and had thorny branches and twigs protruding into accessible areas.

7. On the opposite side of the garage at the rear left exterior of the facility, the fence separating the facility from the neighboring property was observed to be in disrepair, with rusted metal mesh placed over portions of a gray metal fence in an apparent attempt to cover damaged areas, creating sharp and uneven surfaces.

8. At the front exterior of the facility, a tree was observed to be untrimmed, with branches and protruding twigs hanging at an approximate height of three (3) to four (4) feet above ground level, creating a potential hazard for individuals accessing the facility.

9. The emergency exiting plan and emergency phone numbers, Personal Rights, Visiting Policy, Licensing Complaint Poster, Resident council meetings and resident council are not posted in the facility.

10. Signal call system for residents to request assistance was not available in the facility.

An exit interview was conducted, and a hard copy of this report has been furnished to the applicant. Accordingly, LPA will submit a copy of this facility evaluation report to the Central Applications Unit (CAU) for review. If the applicant has questions regarding the status of the application, they have been instructed to communicate with the CAU Analyst assigned to the applicant.