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25 | At approximately 9:10AM, Licensing Program Analysts (LPAs) Felias and Frank arrived unannounced to continue a Required 1-Year Visit and met with Staff Member, Elsa Banton. Licensee, Martha Ghezzehai, arrived during visit at approximately 11AM. Facility is a Residential Home for the Elderly and provides care and assistance for Older Adults. Facility has a plan of operation for dementia care and programming on file. Facility has an approved fire clearance and capacity for 6 non-ambulatory residents. Facility has an approved hospice waiver for 3 individuals. Upon arrival, LPA was informed that there were 5 residents in care, and 3 staff members on-site.
LPAs reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation. LPAs reviewed staff files, resident files and resident medication. All files were all found to be well organized, thorough and contained the required documentation. Staff files had current First Aid and CPR certification. Medication was observed to be centrally stored and secure. Administrator's Certificates for Martha Ghezzehai (7026047740) was current with an expiration date of 05/10/2025 and Miriam Ghezzehai (7026138740) was pending with their renewal application received date as of 09/26/2023. LPAs also cleared the two deficiencies that were cited during visit conducted on 11/19/2024. Copies of Plan of Corrections Letters provided to Licensee.
LPAs requested the following documents to update facility file:
- Designation of Facility Responsibility (LIC 308)
- Emergency Disaster Plan (LIC 610E)
- Updated Personnel Report (LIC 500)
- Updated Liability Insurance
- Active and Current Administrator Certificate
Documents to be submitted to Community Care Licensing (CCL) by due date of 02/07/2025.
No Deficiencies Cited during Visit.
Exit interview conducted. Copy of report discussed and provided to Licensee. Signature on form confirms receipt of documents. |