Inspection Report
Renewal
Census: 3
Capacity: 6
Deficiencies: 4
Nov 26, 2024
Visit Reason
The visit was a renewal licensing study inspection to evaluate compliance with licensing rules and to determine if the facility's license should be renewed.
Findings
The facility was found to be in non-compliance with several rules including outdated resident assessment plans and care agreements, incomplete documentation of assistive device use, and excessively high hot water temperature. A repeat violation was noted from a prior inspection.
Deficiencies (4)
| Description |
|---|
| Resident assessment plans were not updated at least annually for Residents A and B. |
| Resident care agreements were not reviewed and updated at least annually for Residents A and B. |
| Assistive devices used by Residents A and B were not specified in their written assessment plans. |
| Hot water temperature measured as high as 141.8 degrees Fahrenheit, exceeding the allowed range of 105 to 120 degrees Fahrenheit. |
Report Facts
Capacity: 6
Census: 3
Staff interviewed: 2
Others interviewed: 1
Water temperature: 141.8
Corrective action plan due days: 15
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Angelyth Marino | Licensee Designee | Reviewed medication passing procedures and involved in corrective action plan |
| Gilberto Villamizar-Martinez | Administrator | Named as facility administrator |
| Kristine Cilluffo | Licensing Consultant | Conducted inspection and authored report |
Inspection Report
Renewal
Census: 4
Capacity: 6
Deficiencies: 3
Dec 12, 2022
Visit Reason
The visit was conducted as a renewal licensing study for Hearthstone Communities Sterling I to assess compliance with licensing rules and regulations.
Findings
The facility was found to be in non-compliance with rules regarding the use of assistive devices and resident medications, specifically related to Resident A's hospital bed and bed rail not being listed in the assessment plan, lack of physician authorization for therapeutic supports, and improper disposal of discontinued medication.
Deficiencies (3)
| Description |
|---|
| Resident A’s hospital bed and bed rail were not listed in assessment plan. |
| Resident A did not have physician authorization in file for use of hospital bed and bed rail. |
| Resident A had GNP Miconazole 2% powder that was discontinued. Medication should be disposed of once no longer required. |
Report Facts
Number of residents interviewed and/or observed: 4
Number of staff interviewed and/or observed: 2
Capacity: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Angelyth Marino | Licensee/Licensee Designee | Reviewed medication passing procedures with licensee designee |
| Gilberto Villamizar-Martinez | Administrator | Named in identifying information |
| Kristine Cilluffo | Licensing Consultant | Author of the inspection report |
Inspection Report
Original Licensing
Census: 5
Capacity: 6
Deficiencies: 0
May 26, 2022
Visit Reason
The visit was conducted as an original licensing study to determine compliance with applicable licensing statutes and administrative rules for Hearthstone Communities Sterling I, a small adult foster care home.
Findings
The facility was found to be in substantial compliance with licensing rules, including physical environment, staffing, medication management, and resident care requirements. The home was recommended for issuance of a temporary license with a capacity of six residents.
Report Facts
Capacity: 6
Current residents: 5
Staffing ratio: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Angelyth Marino | Licensee Designee | Named as licensee designee and responsible for compliance and administration |
| Gilberto Martinez-Villamizar | Administrator | Named as administrator responsible for daily operations and resident care |
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