Routine inspection·October 15, 2025

Licensing Program Analyst (LPA) Mariana Agban conducted an Annual Required visit and inspection of the facility. LPA met with staff, Perscillla Bance, and explained the reason for the visit. Administrator Anita Ortiz could not attend the annual and staff Ruel Richohermoso was designed for the Administrator. At approximately 10:15 am, with the assistance of staff, LPA took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms are interconnected and battery-operated. There is a carbon monoxide detector that functions properly installed in the hallway between resident rooms. The fire extinguisher is located in the living room and laundry room with a purchase date of 10/04/25. 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. Properly labeled medications were locked in one of the kitchen cabinets. Bedrooms: There were four(4) bedrooms designated for residents' use and two (2) bedrooms designated for staff. All bedrooms, in use by residents, were properly furnished with appropriate beddings and linens with sufficient lighting. Bathrooms: There are three (3) bathrooms designated for residents' use. All bathrooms were properly supplied and had functional fixtures. Hot water temperature was measured from the bathroom sink at 108.7 degrees Fahrenheit. No cleaning supplies or hazardous items were present in each bathroom during the inspection. Common Areas: The common areas were properly furnished. The auditory alarms on all exit doors were on and functional during the visit. The dining room table is large enough to accommodate the facility's capacity. Seating, such as couches, was in good repair and sat the capacity of the facility. The living room has televisions and comfortable furniture. Laundry Area: Laundry detergents were locked in a cabinet, and thus, toxins were inaccessible to residents. Surrounding Grounds: Entry/exits were free of obstruction. (Continue on 809C ) There was furniture appropriate for outdoor use. The outdoor area was free of hazards. There is a swimming pool that is fenced all around its perimeter. The fence was at least five feet high with a gate that was also five feet high. The gate was observed locked, making it inaccessible for residents to enter 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. LPA observed the Administrator's office and garage. Resident Files: LPA conducted a file review of resident records to ensure compliance with licensing forms. LPA observed that R1-R5 files do not have an updated physician report (LIC 602) and Appraisal Needs and Services. Staff Files: LPA also conducted a file review of staff records to ensure forms and training are up to date and in compliance with licensing forms. Medications: Medications and Medication Records were reviewed for proper documentation. LPA observed that R2 did not take his morning medications. S1 stated that they had administered morning medication; however, S1 had used stored bubble packs medications from previous months. LPA also observed that the R3 medication record was not consistent. Temperature: Facility maintains a comfortable temperature of 77 degrees Fahrenheit. Exit interview conducted, citations issued, appeal rights given, copy of this report signed and delivered.