Routine inspection·January 18, 2024

Licensing Program Analyst (LPA) A. Gomez conducted an unannounced 1-year Required visit on this date. LPA met and toured with Administrator, Sheila Melencion. The Administrator currently holds a certificate (#602427740) that expires on 5/11/2025. The facility’s fire clearance was approved for a capacity of 18 which 16 may be non-ambulatory and subject to five (5) hospice waivers. LPA toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 72 degrees Fahrenheit. LPA observed lighting in all rooms that are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 107.9 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of 2-day of perishable foods and a minimum 7-day non-perishable foods. Smoke detectors and carbon monoxide were in operating condition during visit. LPA observed sprinklers throughout the facility. Fire extinguisher was last serviced on 1/09/2024. Fire Drill was last conducted on 01/10/2024. First aid kit was observed to be complete. LPA reviewed 3 staff records and staff have criminal record clearance and are associated to the facility. 3 of 3 have current first aid training. LPA reviewed 4 residents’ records and a sample of medication. No Deficiencies cited. Exit interview conducted and a copy of this report provided