Routine inspection·October 9, 2025

On 10/09/2025 at approximately 09:30 AM, Licensing Program Analyst (LPA), Angelica Segovia conducted an unannounced annual visit to the facility. LPA was greeted by the caregiver and stated the reason for their visit. The Administrator, Fabiola Igid arrived shortly after to assist with today’s visit. LPA asked for the census, Staff/Resident Roster, and Liability Insurance. LPA conducted a physical plant tour at approximately 11:00 AM and the following was noted: The facility is a single-story building with five (5) bedrooms and two (2) bathrooms. The facility is currently occupying five (5) residents. There is a designated staff room. The facility has an approved fire clearance for six (6) non-ambulatory residents. Hospice waiver approved for one (1). Common areas: The living rooms and dining room were observed to be neat, clean, and organized. The rooms were observed to be properly furnished and in good repair. The facility maintains a comfortable temperature at 73°F. LPA observed a fire extinguisher to be located near the hallway’s passageway and dated 8/28/2025. LPA observed required postings such as Long-Term Care Ombudsman, Emergency Disaster Plan, and Personal Rights to be located throughout the common areas. A working telephone was observed. LPA observed the fireplace to be covered and inaccessible to residents. Kitchen: The kitchen was observed to be clean and free from pests. Sufficient supplies of seven (7) day nonperishable foods and two (2) day perishable foods were observed. Knives/sharps were observed to be kept in a locked kitchen drawer. The cleaning solutions/toxins were observed to be kept locked underneath the kitchen sink. Kitchen appliances were observed to be working and in proper condition. (continued on LIC 809-C) Bedrooms: The residents’ rooms are adequately furnished with appropriate furniture and lighting system. Hallways/passageways are lighted appropriately. Extra linens/covers were observed to be stored in cabinets located within the hallway’s passageway. Staff Room: LPA observed the staff room to be kept locked. Bathrooms: The bathrooms were checked for cleanliness and proper operation. LPA observed appropriate grab rails and slip-resistant mats to be in proper condition. Backyard: The backyard of the facility is equipped with a designated shaded area with outdoor furniture for residents. LPA observed there to be a locked shed. There is no body of water located at the facility. Laundry Room: The laundry room was observed to be located near the garage. LPA observed cleaning solutions and toxins stored appropriately within the laundry room and inaccessible to residents. The laundry appliances were observed to be working and in proper condition. Garage: The garage was observed to be located near the laundry room and can be accessed from inside of the facility. The garage was observed to be kept locked and used for storage purposes. Extra refrigerator and freezer with additional food for residents was observed. Medications: The medications along with staff and residents’ files were observed to be kept in a locked filing cabinet located in the hallway’s passageway. First-aid kit observed to be equipped with but not limited to bandages, scissors, digital thermometer and tweezer. Smoke detectors and carbon monoxide observed to be working properly and were tested. Residents/Staff Records: LPA conducted a complete file review of resident records. Resident records appeared to be complete. Staff records: LPA conducted a complete file review of three (3) staff records. Staff records appeared to be complete and updated. There were no immediate health and safety hazards observed during the day of inspection. Exit interview conducted and a copy of this report was provided to the Administrator.