Routine inspection·April 8, 2025

Licensing Program Analyst (LPA) Daiquiri Boyd arrived at the facility unannounced to conduct a required annual visit. LPA was granted entry by staff and explained the purpose of the visit. Licensee/Administrator Marilen Gonzales responded to the facility to assist with the visit. LPA completed the inspection with staff Ann Lorio. LPA toured the home inside and outside. No exits were found to be obstructed. Temperature of the home was set at 73 degrees F. Last Fire and Emergency Drill was conducted on 3/2/25. Fire extinguisher serviced on 2/7/2025. The home has 5 bedrooms and 2 bathrooms. All bedrooms are nicely furnished with personal affects, beds, tv's, chairs, lighting, dressers, bedside tables, and ceiling fans. Bathrooms delivered hot water at a temperature of 115 degrees F. Fire place is not used. LPA observed a fresh supply of fruits and vegetables, perishable and non-perishable foods. LPA did not observe a supply of emergency food and water. Disaster drill needs more information and LPA requested more details be added to the Emergency and Disaster Plan. LPA requests that an updated floor plan with location of utility shut-off's be provided to Licensing. LPA observed the home to be in good condition with flooring, walls, lighting, counter tops, fixtures, all in good working order. LPA observed a supply of linens in the hall way closet. All hazardous chemicals and item are kept stored in a locked hall closet. The washer and dryer are kept in the hall way area. LPA spoke to staff regarding keeping this area clean and the dryer properly maintained to avoid a build-up of lint. Smoke and carbon monoxide detectors were observed and checked and found to be in working order. The upstairs area of the home is designated at staff only as LPA verified by observation. Resident medications and medication records were reviewed. LPA reviewed four resident files and four staff files. (continued on next page) Back yard area is clean and free of hazards, pool on premises has a locked fence and gate. The back yard has two sheds, neither contains any hazards as observed by LPA. LPA requests that updated forms be sent to CCL by 4/18/25: LIC500, LIC610D, Liability Insurance, LIC308. Signature of staff confirms receipt of this document.