Routine inspection·May 14, 2026

On 04/09/2025 at 10:50AM, Licensing Program Analyst (LPA) T. Syess-Gibson conducted an unannounced 1-Year Required inspection. LPA met with Zsymond Gregorio , Caregiver and explained the purpose of the visit. Zsymond called the Administrator to advise of visit. Jamie Ruiz, Administrator arrived at 11:41AM. LPA explained purpose of visit. Administrator currently holds a certificate (#7035384740) that expires on 10/04/2027. Facility has census of 6. The facility’s fire clearance was approved for six (6) non-ambulatory residents. LPA toured the facility with Administrator including but not limited to bedrooms, bathrooms, kitchen, common area and back yard. The facility consists of six (6) bedrooms and three (3) bathrooms. LPA did not observe any bodies of water. A comfortable temperature is maintained at 73 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 113.2 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of 7-day supply of non-perishable and 2-day of perishable foods. Continue on LIC809C.... Continued from LIC809 Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last purchased on 04/13/2026. Emergency Disaster Plan was last posted on 03/10/2026. First aid kit was observed to be complete. Fire drill was last conducted on 03/06/2026. LPA reviewed six (6) resident records, and six (6) staff records, and they were current and complete. LPA also reviewed a sample of medication. LPA requested the following documents to be submitted to CCLD by 05/24/2026. LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance No deficiencies were cited during visit. Exit interview conducted, A copy of this report provided to Jamie Ruiz