Routine inspection·September 11, 2025

On this day, September 11, 2025, Licensing Program Analyst (LPA) Delmundo arrived unannounced to conduct an annual required inspection. LPA met with Executive Director (ED) Diane Pederson, and informed the reason for visit. LPA toured the facility inside out with ED. Facility is a 3 story building. LPA inspected the common areas, library, kitchen, dining room, yard, common bathroom and laundry room on the second floor. Food supplies were observed good for 2 days of perishables and 7 days of non-perishables. Freezers and refrigerators temperatures are checked by kitchen staff and recorded daily, and records showed temperatures were within Regulations range. LPA randomly selected 8 residents apartments for inspection - 2 on the first floor, 3 on the second floor and 3 on the third floor. Hot water temperature in one of the resident's apartments was tested and measured at 110.6 degrees Fahrenheit. The 2 in 1 carbon monoxide and smoke detectors in another resident's apartment was tested and observed in working condition . Facility has evacuation chairs on stairwells . Facility conducts disaster drills at least every quarter, and records showed last conducted August 16, 2025 LPA reviewed 5 staff and 5 resident's files, and interviewed 4 residents. Medications checked, and compared with doctor's orders and LIC622 Centrally Stored Medication and Destruction Record. Facility does not handle resident's cash resources/P&I. .....continued on 809C LPA received the following updated/current documents on this same day: 1. LIC308 Designation of Facility Responsibility 2. LIC500 Personnel Report 3. LIC610E Emergency Disaster Plan (9 pages) 4. $3M Liability Insurance certificate No deficiency cited during today inspection. Exit interview conducted, and copy of this report provided.