Inspection Report
Annual Inspection
Census: 3
Capacity: 5
Deficiencies: 3
May 10, 2024
Visit Reason
Licensing Program Analyst Magda Malcore made an unannounced visit to the facility to conduct a required annual inspection of the Residential Care Facility for the Elderly (RCFE).
Findings
The inspection found the facility generally maintained a safe and sanitary environment with adequate care and supervision, but cited deficiencies including lack of a current quarterly emergency drill, overgrown foliage blocking an outdoor passageway, and failure to maintain an approved hospice waiver increase on file.
Deficiencies (3)
| Description |
|---|
| The Licensee did not maintain a current quarterly emergency drill on file; the last drill was conducted on 8/4/23. |
| The Licensee did not maintain the backyard free of obstruction as overgrown scrubs/foliage blocked passageway. |
| The Licensee did not maintain an approved Hospice waiver increase on file while having three residents receiving Hospice Care but only an approved waiver for two. |
Report Facts
Residents receiving Hospice Care: 3
Capacity: 5
Census: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Magda Malcore | Licensing Program Analyst | Conducted the inspection and authored the report. |
| Karen Clemons | Licensing Program Manager | Named as Licensing Program Manager overseeing the inspection. |
| Aniko A. Barlow | Administrator | Facility Administrator met with the Licensing Program Analyst during the inspection. |
Inspection Report
Annual Inspection
Census: 3
Capacity: 5
Deficiencies: 0
Jul 7, 2022
Visit Reason
An unannounced annual inspection was conducted with an emphasis on infection control to evaluate compliance with Community Care Licensing guidelines.
Findings
The inspection found no deficiencies. The facility demonstrated proper infection control measures including signage, hand hygiene supplies, PPE use, and staff training. The facility has a designated infection control lead and plans for COVID-19 testing, isolation, and monitoring.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Aniko Barlow | Administrator | Met with Licensing Program Analyst during inspection and informed of visit purpose. |
| Bernadette Allen | Licensing Program Analyst | Conducted the unannounced annual inspection. |
| Karen Clemons | Licensing Program Manager | Named in report header. |
Inspection Report
Annual Inspection
Census: 3
Capacity: 5
Deficiencies: 0
Aug 5, 2021
Visit Reason
Licensing Program Analyst Yolanda Delgado made an unannounced visit to the facility to conduct an annual inspection with an emphasis on infection control.
Findings
No deficiencies were cited during the inspection. The facility demonstrated proper infection control measures including signage, hand hygiene supplies, cleaning provisions, and PPE use. The facility has a designated infection control lead and a plan following Community Care Licensing guidelines for COVID-19 testing, isolation, cleaning, and monitoring residents.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Yolanda Delgado | Licensing Program Analyst | Conducted the annual inspection visit. |
| Aniko Barlow | Administrator | Met with Licensing Program Analyst during the inspection. |
| Efren Malagon | Licensing Program Manager | Named in the report as Licensing Program Manager. |
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