Routine inspection·August 26, 2025

On 08/26/2025 at 3:15PM, Licensing Program Analyst (LPA) T. Syess-Gibson conducted an unannounced 1-Year Required inspection. LPA met with Shirley Virden, Administrator, explained the purpose of the visit. The Administrator currently holds a certificate (#7007630740) Expires 05/02/2027. The facility’s fire clearance was approved for two (2) ambulatory and four (4) non ambulatory residents. LPA toured the facility with Shirley Virden, Administrator including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of five (5) bedrooms and two and half (2 1/2) bathrooms. All outdoor and indoor passageways are kept free of obstruction. LPA did not observe any bodies of water. A comfortable temperature is maintained at 77 degrees Fahrenheit. LPA observed lighting in all rooms is adequate for the comfort and safety of the residents. The hot water temperature in the resident’s shared bathroom was measured at 105.3 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and nonskid mats. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 06/17/2025. Emergency Disaster Plan was last posted on 07/05/2025. First aid kit was observed to be complete. Fire drill was last conducted on 07/05/2025. Continued LIC809C. Continued from LIC809 LPA reviewed five (5) residents records and three (3) staff records, and they were current and complete. The following forms to be updated and submitted to CCLD by 09/02/2025: LIC 500 Personnel Report LIC 400 Affidavit Regarding Client/Resident Cash Resources LIC 402 Surety Bond LIC610E Emergency Disaster Plan LIC308 Designation of facility responsibility No deficiencies observed during visit. Exit interview conducted and a copy of this report provided to Shirley Virden.