Routine inspection·March 24, 2026

On 03/24/26, at 9:35am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, annual visit. Dolores Ayson , Caregiver was advised of the visit. Edelwina Calic a Administrator was called and arrived about ten (10) minutes later. LPA asked for the census, resident, and staff files. The facility is a one (1) story home that has a total of three (03) bedrooms and two (02) bathrooms. The facility has a hospice waiver approved for six (06) residents approved on 10/2022. Last fire drill/Fire Alarms were conducted on 03/01/2026. The living and dining room are neat and clean. The smoke and carbon monoxide detectors are hardwired, interconnected and observed to be operational. Fire extinguisher is located in the kitchen, observed to be full and last purchased on 02/2026. There is a signal system in the house. Kitchen is sufficiently stocked with at least two (02) days perishable and seven (07) days non-perishable food. Frozen foods are wrapped and stored appropriately. Kitchen cabinets contain extra food. Knives and sharps are observed to be locked and inaccessible to residents in one (1) of the top cabinets on your right side. The medication is kept in the kitchen area locked and inaccessible to the residents in a cabinet. LIC 809C-continued There is one (1) washer and dryer next to the kitchen area. The chemicals/toxins are kept in the patio area enclosed locked and inaccessible to residents. There is another pantry in the hallway with food. Living Room and Dining Room: LPA observed the living room and furniture to be clean and in good repair. LPA observed the dining area to be clean and in good repair. The dining room area has five(5) chairs for residents. The facility temperature is between 73 degrees Fahrenheit. There is another fire extinguisher at the entrance of the facility with a recent date of 02/2026. Bedrooms: Facility has three (3) bedrooms. All three (3) bedrooms are shared and currently occupied. Bathrooms: There are two (2) bathrooms that have proper grab bars, non-skid mats. The bathrooms contained a trash can with tight-fitting lid. Hot water was tested and measured between 113.7 Fahrenheit within regulations. Outside/Backyard: There is no garage. The outside/backyard has furniture for residents to have proper There is a no pool/bodies of water. Administrative: The administrative Certification is current. There is a yes sign, Ombudsman, Personal Rights Council and Personal Property Procedures at the entrance of the facility. The liability insurance is dated 07/01/26. Staff/Resident Files: LPA reviewed six (6) resident files and three (3) staff files. An exit interview was conducted, no citation(s) were issued and a copy of this report was given to the administrator.