Routine inspection·September 15, 2025

On 09/15/25 Licensing Program Analyst (LPA) Lorena Casillas arrived at the facility for an unannounced one (1) year Required visit and was greeted by a caregiver. Caregiver called administrator and LPA was informed that the Administrator, Monica Gory, would not be able to meet with LPA. LPA informed the Administrator of the purpose of the visit via phone and the Administrator designated caregiver Julissa Dubon Hall to sign the report. Three (3) out of the five (5) residents were observed to be in their room sleeping, watching TV and/or resting. Two (2) residents were attending day program. A tour of the physical plant was conducted with the designee at 12:00 pm. The facility has five (5) bedrooms and two (2) bathrooms currently occupying five (5) residents. One (1) bedroom is designated for staff use only. The facility is Fire Cleared for four (4) ambulatory, two (2) non-ambulatory residents, and a hospice waiver for one (1). Currently the facility has no residents on hospice. Administrative: Annual fee is current. LIC 500, Client roster and Liability insurance will be emailed to LPA. Infection control: LPA previously reviewed the facility mitigation plan (approved on 03/ 1 8/21) to make sure the licensee was following current infection control recommendations. Resident Rooms: LP A observed rooms to have the appropriate bedding, nightstand, a chair and sufficient lighting for each resident . LPA observed the staff room to have a locked filing cabinet for staff and resident files. Currently the staff office has an extra freezer, and extra supplies. Continued on LIC809-C Food Inspection: LPA conducted a tour of the kitchen at 12:20 pm and observed there to be sufficient stock of two-day perishable and seven-day non-perishable foods. Frozen foods are properly wrapped and stored. Food storage and preparation areas are clean and inaccessible to pests. LPA observed all knives and sharp objects being locked and inaccessible to residents in care. The Medication cabinet was in the kitchen and was observed to be locked and inaccessible to residents in care. There is a locked medication refrigerator in the hallway for refrigerated medication. Bathrooms: At 12:30 pm LPA observed all bathrooms to have non-skid mats, grab bars, and the appropriate wash your hands signs posted. Hot water was tested and measured within regulation at 118.2˚F. Living and dining: LPA observed the living room to be neat and clean along with the dining room. The facility maintains a temperature of 78°F. The dual smoke detectors and carbon monoxide detectors were tested and observed to be operational at 12:40 pm. There are two (2) fire extinguishers, one (1) is in the kitchen and one (1) is in the hallway. The Fire extinguishers were observed to be full and last purchased on 10/22/2024 and 11/10/2024. Laundry: LPA observed the laundry room to not have any chemicals or hazardous items. Cleaning supplies are kept locked in a hallway closet outside of laundry room. Physical environment: LPA toured the outside area of the facility at 12:50 pm. LPA observed appropriate outdoor furniture, with a covered shaded area for clients . No bodies of water on the premises. Garage: LPA observed no garage in the facility. Resident and Staff Files : LPA conducted a file review of resident files at 01:00 pm. Staff files were not in the facility. LPA spoke to Administrator via phone and Administrator admitted to not having files in the facility for review. A citation will be issued. LPA explained the importance of having files readily available for licensing to inspect. Interviews : LPA conducted interviews of staff and residents at 03:00 pm. Citation issued. Exit interview was conducted, and a copy of this report was provided to designee.