Routine inspection·December 5, 2024

Licensing Program Analyst (LPA) Daiquiri Boyd arrived at the facility unannounced to conduct a required annual visit. LPA explained the purpose of the visit and was granted entry by Caregiver, Margarita Viloria. Administrator, Phoeun Marez was called and she promptly arrived. The residence was set at 73 degrees F temperature and free of passageway obstructions inside and outside. LPAs observed six bedrooms in the residence. Residents' rooms were toured and inspected. Rooms were found to be clean, and furnishing was in good condition. Water temperature was checked and was at 114.8 F. Kitchen toured, supply of food observed, and food stored properly for perishable and nonperishable. Medication and knives are locked in the kitchen area. Cleaning supplies are locked and stored in the garage and under the kitchen sink. Smoke detectors and carbon monoxide were checked and operating. Fire extinguishers was serviced on 7/2/2024. Last drill completed on 10/02/24. There was outdoor seating for the residents. Outdoor area was clean and free of obstruction. During the visit a file review was conducted for four residents and three staff files. Administrator Certificate was expired and LPA was shown the letter confirming the submission of forms for a new certificate. LPA noted a water spot on the ceiling of an unoccupied resident room. LPA advised Administrator to have a Licensed professional inspect the roof and gutters above the area. An exit interview was conducted, and a copy of this report was provided to Administrator whose signature confirms receipt. LPA requested the following updated forms faxed to CCLD by 12/19/24: Administrative Organization (LIC309), Personnel Report (LIC 500), Proof of current Liability Coverage.