Routine inspection·October 13, 2025

Licensing Program Analyst (LPA) Mariana Agban conducted an Annual Required visit and inspection of the facility. LPA met with Administrator Sofia Alvarez and explained the reason for the visit. At approximately 10:10 am, with the assistance of the Administrator, LPA took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms are hardwired and appeared operational. There is a carbon monoxide detector that functions properly installed in the hallway between resident rooms. There are fire extinguisher located in the kitchen and living room, they were observed to be full and last bought on 12/07/24. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives were stored in a locked drawer in the kitchen. Bedrooms: There were four (4) bedrooms designated for residents' use. Two (2) bedrooms is designated for private use, and two (2) rooms are shared. All four bedrooms, in use by residents, were properly furnished with appropriate beddings and linens with sufficient lighting. Bathrooms: There are two (2) bathrooms designated for residents' use. Both bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured from the bathroom sink at 105.5 and 106.7 degrees Fahrenheit. No cleaning supplies or hazardous items were present in each bathroom during the inspection. Common Areas : These included the living room and dining area. The common areas were properly furnished. There is a fireplace that is properly screened. The fireplace is non-functional. No key to the fireplace, and fireplace tools were not present. The auditory alarms on all exit doors were on and functional at the time of the visit. The dining room table is large enough to sit the capacity of the facility. Seating such as couches where in good repair and sit the capacity of the facility. Properly labeled medications were locked in one of the dining cabinets. (Continue on 809C) Surrounding Grounds : Entry/exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards. The gates at both sides of the home were checked to ensure no locks were installed, and that exits and passageways were clear for emergency evacuation. Garage/ Laundry: The laundry area is located in the garage, which is inaccessible to residents. Garage was observed pilled up with old mattresses, wheelchairs and chairs. Administrator stated that they are working on decluttering the garage area. Resident Files : LPA conducted a file review of resident records to ensure compliance of licensing forms. LPA observed that R1, R3, and R4 files do not have updated Medical Assessment (LIC 602). In addition R1-R5 files do not have an updated Appraisal Needs and Services Plan. Staff Files : LPA also conducted a file review of staff records to ensure forms and training are up to date and compliance with licensing forms. LPA observed that neither S1 nor S2 have updated CPR/First Aid certificates. Medications : Medication and Medication Records were review for proper documentation. Temperature: Facility maintains a comfortable temperature of 77 degrees Fahrenheit Exit interview conducted, appeal rights given, copy of this report signed and delivered.