J & S Home Care II

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Mariana Agban conducted an Annual Required visit and inspection of the facility. LPA met with Administrator Sofia Alvarez and explained the reason for the visit. At approximately 10:10 am, with the assistance of the Administrator, LPA took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms are hardwired and appeared operational. There is a carbon monoxide detector that functions properly installed in the hallway between resident rooms. There are fire extinguisher located in the kitchen and living room, they were observed to be full and last bought on 12/07/24. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives were stored in a locked drawer in the kitchen. Bedrooms: There were four (4) bedrooms designated for residents' use. Two (2) bedrooms is designated for private use, and two (2) rooms are shared. All four bedrooms, in use by residents, were properly furnished with appropriate beddings and linens with sufficient lighting. Bathrooms: There are two (2) bathrooms designated for residents' use. Both bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured from the bathroom sink at 105.5 and 106.7 degrees Fahrenheit. No cleaning supplies or hazardous items were present in each bathroom during the inspection. Common Areas: These included the living room and dining area. The common areas were properly furnished. There is a fireplace that is properly screened. The fireplace is non-functional. No key to the fireplace, and fireplace tools were not present. The auditory alarms on all exit doors were on and functional at the time of the visit. The dining room table is large enough to sit the capacity of the facility. Seating such as couches where in good repair and sit the capacity of the facility. Properly labeled medications were locked in one of the dining cabinets. (Continue on 809C) Surrounding Grounds: Entry/exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. The gates at both sides of the home were checked to ensure no locks were installed, and that exits and passageways were clear for emergency evacuation. Garage/ Laundry: The laundry area is located in the garage, which is inaccessible to residents. Garage was observed pilled up with old mattresses, wheelchairs and chairs. Administrator stated that they are working on decluttering the garage area. Resident Files: LPA conducted a file review of resident records to ensure compliance of licensing forms. LPA observed that R1, R3, and R4 files do not have updated Medical Assessment (LIC 602). In addition R1-R5 files do not have an updated Appraisal Needs and Services Plan. Staff Files: LPA also conducted a file review of staff records to ensure forms and training are up to date and compliance with licensing forms. LPA observed that neither S1 nor S2 have updated CPR/First Aid certificates. Medications: Medication and Medication Records were review for proper documentation. Temperature: Facility maintains a comfortable temperature of 77 degrees Fahrenheit Exit interview conducted, appeal rights given, copy of this report signed and delivered.the state’s words, verbatim · CDSS document, Oct 13, 2025

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Gary Tan met with Administrator Sofia Alvarez for a One (1) year required visit for this facility. LPA explained the reason for the visit. A tour of the physical plant was conducted at 12:35 PM and the following was noted: There is only one entrance being utilized at the facility. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks are available. The facility had submitted and approved Infection Control and Mitigation plan. Signs to wear a mask and other Covid 19 prevention protocol signs were posted indoors.. Hand washing, coughing etiquette, physical distancing and other necessary signs were posted in the bathroom and all over the facility. The facility has a designated visitors' area at the backyard. The facility has sufficient stock of PPE in the storage room. The facility has four (4) bedrooms and two (2) bathrooms currently occupying five (5) residents. An additional one (1) bedroom and one (1) bathroom is designated for staff use. The facility is fire cleared for six (6) non-ambulatory resident. Hospice waiver for three (3) residents. Physical environment was checked for cleanliness and condition. Walls, windows, ceilings, floors and floor coverings and doors were checked, the following was noted: Living and dining room furniture were also checked. The living room is neat and clean along with the dining room. The facility maintains a comfortable temperature at 75°F. Dual smoke/carbon monoxide alarms were tested and observed to be operational. There are fire extinguisher located in the kitchen and living room, they were observed to be full and last bought on 12/07/24. The backyard of the facility has outdoor furniture, with a covered shaded area for clients. There is no body of water in the facility. There is a locked tool shed at the far end of the backyard. (continued on LIC 9099-C) The garage is attached to the house and observed to be locked, it has to go through the staff room to get into the garage. It is also being used as storage for miscellaneous supplies , PPE and old equipment. Laundry room is located adjacent to the kitchen going to the staff room and garage. All the laundry detergents, cleaning solutions, toxins and other chemicals are observed to be locked in the laundry room and inaccessible to residents. Food Service/Kitchen area was sufficiently stocked with two (2) days perishable and seven (7) days of non-perishable food. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. All sharps and knives were also observed to be locked in the kitchen cabinet below the sink. The Clients' rooms are adequately furnished with appropriate furniture and lighting system. Hall ways/passage ways are lit. Clients have sufficient amounts of personal hygiene product which is provided by the licensee. Staff Rooms: Could only be accessed through the Laundry Room and observed to be locked. No medications are observed in the staff room. The bathrooms were checked for cleanliness and proper operation. LPA observed the appropriate grab bars for each toilet, bathtub and shower. Sink in the bathrooms were removed and under construction. The hot water temperature measured at a range 109.1°F to 113.8°F. Towels and washcloths are not shared. There is enough clean linen available in stock at the cabinet. Medications: LPA observed medication in the dining area cabinet to be locked and inaccessible to residents. Medications are listed on the centrally stored medication and destruction record. There is a complete first aid kit located in the living room cabinet. Client records: Client records are reviewed. all residents' file appeared to be complete and updated. Staff records: LPA conducted a complete file review of staff records. Staff records appear to be complete and updated. Disaster drill was last conducted on 11/12/24. Required posting are observed to be complete and current and displayed properly at the facility. Exit interview conducted and copy of this report issued.the state’s words, verbatim · CDSS document, Dec 7, 2024

Type of visit: Required - 1 Year

On 10/12/23 Licensing Program Analyst (LPA) Mariana Agban conducted an Annual Required visit and inspection of the facility. Upon arrival, LPA was greeted by the Administrator Sofia Alvarez and explained the reason for the visit. A tour of the physical plant was conducted at 10:20AM. Kitchen: All knives and sharps are observed to be locked in a kitchen drawer and inaccessible to residents. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Sharp objects were stored in locked drawers and cabinets. LPA observed fully stocked first aid kit in the kitchen drawer. Laundry Area: located through the kitchen. Appliances observed to be in good repair. The door was locked and thus laundry detergents were inaccessible to residents. Temperature: Facility maintains a comfortable temperature of 78 degrees Fahrenheit. Surrounding Grounds: Entry/exits were observed to be locked. The outdoor area was clean and free of hazards. There is large deck with a patio table and chairs shaded for clients use in the backyard. Patio furniture observed to be in good repair with adequate seating for the residents. Smoke Alarms and Carbon Monoxide: The fire extinguisher is located in the kitchen, observed to be fully charged and was purchased on 10/22/22. Bathrooms: LPA observed all bathrooms are clean and in good repair. Properly supplied with toilet papers, soap and paper towels. The hot water temperature measured at 114.8°F. LPA observed appropriate grab bar and non-skid mat. Bedrooms: There were four (4) bedrooms designated for residents' use. Two (2) bedrooms are private and one (2)shared. All bedrooms were clean, properly furnished and had sufficient lighting. Common Areas: This includes the living room dining areas were appropriately furnished and lighting was adequate. The garage: is being used for an extra storage and was observed to be locked. No deficiencies issued during today’s visit. Report was signed and delivered and an exit interview was conductedthe state’s words, verbatim · CDSS document, Oct 12, 2023