Cma Care Home

On 07/10/24 at 11:15 am Licensing Program Analysts (LPA) J. Clancy-Czuleger arrived unannounced to do an annual inspection. LPA meet with Administrator Camille Abolencia and explained the purpose of the visit. LPA inspected the facility inside out. There is no body of water. Physical plant is consistent with the facility sketch received by Central Application Bureau (CAB) and approved by the fire department. LPA inspected the living room, dining area, kitchen, bedrooms, hallways, bathrooms, side and backyards. Bedrooms were observed appropriately furnished with adequate lighting and drawers. Facility has sufficient towels, extra bed sheets and comforters. Equipment and supplies for residents' personal hygiene are available and on site. Dinner and silver wares were observed sufficient for residents' use. Food supplies checked and observed good for seven days of non-perishables. Facility was observed equipped with refrigerator, microwave, dishwasher, washer and dryer. Cabinet for knives, cleaning supplies, and central storage for medications were observed with locks. Activity supplies were available. Outdoor activity space was observed furnished with tables, chairs and shade. The facility has a mitigation plan. At 11:42 am LPA reviewed 5 residents records. At 12:05 pm, LPA reviewed 2 staff records and 2 of 2 were fingerprint cleared and associated to the facility. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.

On 7/24/2023 starting at 12:50 PM, Licensing Program Analyst (LPA) L. Fici arrived unannounced to conduct 1-Year Annual Required Inspection. LPA met with Imelda Cruz, Licensee and explained the purpose of the visit. The facility’s fire clearance was approved for all six (6) non-ambulatory residents, and approved for three (3) hospice waivers. Upon entry, LPA observed three (3) staff and one (1) residents present during inspection. Starting at 1:34 PM, LPA toured facility with licensee including but not limited to five (5) bedrooms, three (3) bathrooms, kitchen, common area and backyard. The facility consists of 5 total bedrooms which 4 bedrooms are private, and 1 shared room. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 73 Degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents'. The hot water temperature in residents’ common area bathroom was measured at 106.7 Degrees Fahrenheit. Residents’ bathrooms are equipped non-skid mats. There is a minimum of one-week supply of nonperishable and 2-day supply of perishable foods. Sharps and toxins were locked and inaccessible to residents'. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was observed last serviced on 5/15/2023. First aid kit was observed to be complete. Continue on Lic809-C 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Continued from Lic809 Starting At 1:57 PM, LPA reviewed 3 staff records. At 2:15 PM, LPA reviewed 5 of 6 residents' records. At 2:50 PM, LPA reviewed a sample of 5 of 6 residents' medications. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 7/31/2023: · LIC 308 Designation of Administrative Responsibility · LIC 500 Personnel Report · LIC 610E Emergency Disaster Plan (9 Pages) · Liability Insurance · Surety bond No deficiencies cited during visit. Exit interview conducted with ADM, and a copy of this report provided.

On today’s date, at 2:00 PM, Licensing Program Analyst (LPA) L. Fici and Licensing Program Manager (LPM) Y. Flores-Larios arrived unannounced to conduct an Annual Infection Control Visit. LPA and LPM was greeted by Care staff- Daisy Lazaga at the front door entrance. LPA and LPM shortly met with Licensee- Imelda Cruz shortly after. During the inspection, LPA and LPM toured facility including but not limited to front entrance, kitchen, common areas, hand washing stations, bedrooms, bathrooms, and backyard. LPA and LPM observed COVID-19 signage throughout the facility. Hand washing signs were posted at hand washing stations. LPA and LPM observed paper supplies and PPEs are sufficient. Facility has a sufficient 2-day perishable and 7-day perishable food supply. Common areas are disinfected frequently throughout the day. Water temperature is measured at 105.1. Fire extinguisher was last serviced on 6/11/2022. Carbon monoxide and smoke detector are operable. Facility passages inside and out free of obstruction and does not pose a health and safety risk for persons in care. During record review, LPA and LPM observed facility has a copy of their Infection Control Plan on file. No deficiencies cited during visit. Exit interview conducted with Licensee and copy of this report provided.