Tita Guest House

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 staff, and explained the reason for the visit. Administrator, Reynaldo Del Rosario could not attend the annual for the day due his exposure to COVID. Assistant Administrator Catherine Del Rosario, came in his place. At approximately 09:25 am, with the assistance of staff, LPA took a tour of the physical plant. Screening area is located immediately upon entrance. Sign in sheet, hand sanitizer, gloves and masks were observed in the entry area. LPA tested the smoke alarms and carbone monoxide and they were function properly.. LPA observed the fire extinguisher in the kitchen with purchase date Jan 12, 2026. 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. Properly labeled medications were locked in one of the kitchen cabinets. The laundry area is located adjacent to the kitchen. LPA observed laundry was locked and all toxins are inaccessible to residents. Bedrooms: There were five (5) bedrooms designated for residents' use. Four (4) bedrooms are designated for private use, and one (1) room is shared. All five bedrooms, in use by residents, were properly furnished with appropriate beddings and linens with sufficient lighting.Bathrooms: There are three (3) bathrooms designated for residents' use. All bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured from the bathroom sink at 106.5, 113.0 and 108.7 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. The auditory alarms on all exit doors were on and functional at the time of the visit. (Continue on 809 C) 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. Surrounding Grounds: Entry/exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. LPA checked the gates at both sides of the home to ensure no locks were installed, and that exits and passageways were clear for emergency evacuation. Resident Files: LPA reviewed resident records and observed the following deficiencies: Resident #1 (R1) and Resident #6 (R6) files did not contain physician reports. R1 had full bed rails in place and was not receiving hospice care. Residents #2 (R2), #3 (R3), and #4 (R4) had half bed rails without physician orders. Resident #2 (R2), #3 (R3), and #5 (R5) files did not contain an Appraisal Needs and Services Plan. Resident #1 (R1), #4 (R4), and #5 (R5) files did not include a Safeguards for Property and Valuables form (LIC 621). Additionally, Resident #6 (R6) did not have a hospice care plan on file. 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. Medications: Medication and Medication Records were not consist. LPA was unable to audit medications due to inconsistency and incomplete records for all the residents. Temperature: Facility maintains a comfortable temperature of 74 degrees Fahrenheit Exit interview conducted, citations issued, appeal rights given and copy of this report signed and delivered.the state’s words, verbatim · CDSS document, Jan 16, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Gary Tan met with staff Rexelon Gaurano who called Assistant Administrator Catherine Del Rosario for a One (1) year required visit for this facility. Assistant Administrator Del Rosario arrived twenty (20) minutes later. LPA explained the reason for the visit. A tour of the physical plant was conducted at 9:25 AM 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 three (3) bathrooms currently occupying six (6) 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, one (1) of which maybe bedridden on rooms 1-4. 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 is a fire extinguisher located in the kitchen and observed to be full and last bought on 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 an structure at the backyard and two (2) locked tool sheds at the far end of the backyard. (continued on LIC 9099-C) The garage and was converted into offices for the staff. The offices were locked during visit. It is also being used as storage for miscellaneous supplies. Laundry room is located adjacent to the kitchen going to the rear end/backyard exit.. 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. 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: is currently being used as a lounge/rest area only. The bathrooms were checked for cleanliness and proper operation. LPA observed the appropriate grab bars for each toilet, bathtub and shower. The hot water temperature measured at a range 112.3°F to 119.0°F. Towels and washcloths are not shared. There is enough clean linen available in stock at the cabinet. Medications: LPA observed medication in the kitchen 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. One (1) out of two (2) dementia residents did not have a current medical assessment on file. One (1) out of six (6) residents did not have physician's report on file and one (1) out of six (6) residents did not have pre admission appraisal on file. 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 10/10/24. 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 8, 2024