Routine inspection·July 9, 2025

At 9:45a.m., Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted an unannounced Required One (1) year inspection to the facility. LPA met with caregivers that granted entry to the facility and explained the reason for the visit. Caregiver, Estrelita contacted Co-Administrator via-phone and later the Co-Administrator joined today’s visit. At approximately 10:15a.m., LPA and Administrator conducted a physical plant tour inside and out. During the tour, LPA observed that the facility is a home located in a residential community. Required postings were observed in the entry area and hallway. The smoke alarms are operational, located in each bedroom, kitchen and hallways. This a carbon monoxide detector that functions properly. The fire extinguisher is in the kitchen and office with purchased date of 11/02/2024. During the visit the facility isat 73 degrees Fahrenheit. The facility is fire cleared for six (06) non-ambulatory residents; one (1) bedridden; four (4) hospice waiver. Fire Emergency drill was last conducted on 05/05/2025. The facility is currently occupying five (05) residents. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Kitchen: LPA observed kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPA found at least two (02) days perishable and seven (07) days non-perishable food at the facility that is properly stored. Frozen foods are wrapped and stored properly as well. Knives were stored in a locked drawer in the kitchen. Food storage and preparation areas are clean Cont. on LIC 809-C Cont. from LIC 809 and inaccessible to pests. Garbage cans have tight fitting covers. Toxic cleaning supplies were stored and locked away in the laundry room closet. Medications: are in a centrally stored and locked medication cabinet in dining area, including over-the-counter medicines; medications are properly labeled and checked for expiration dates. Each centrally stored prescription and PRN medication has been logged in the medications log with proper documentation from the resident’s doctor. First-aid has all proper items and were observed to be stored in a locked cabinet in the dining area. Laundry Room: LPA observed a washer and dryer machines located behind to the kitchen. Bedrooms: LPA observed six (6) bedrooms designated for residents' and staff use. Bedrooms #1-#4 are for private used, bedroom #5 is a shared and bedroom #6 is staff room. All of the residents bedrooms were properly furnished with appropriate dresser, beddings, and linens with sufficient lighting. Hallways are well lit. Linens are stored in hallway closet and observed to have ample supply of clean linen, comforters, and towels in facility. Bathrooms: LPA observed two (02) bathrooms to be clean, sanitary and with necessary supplies. The appropriate grab bars and mats in the shower. Hot water temperature measured at a range of 108.9°F to 109.4°F and within the required range. Resident’s personal hygiene supplies are kept separate in plastic containers. Towels and washcloths are not shared. Common Areas: These included the dining area and living room for residents. The common areas were properly furnished and observed to be in good repair. Residents dining table fits six (06) residents. No obstructions and/or tripping hazards throughout the facility. There are no issues with Fire Clearance. Surrounding Grounds : Entry and exits were free of obstruction. The facility has appropriate outdoor furniture with a shaded covered area for residents and visitors. The outdoor area was enclosed, and no bodies of water were observed. Garage: The garage stores extra supplies and observed to be locked and inaccessible to residents in care. Staff Files : they have criminal record clearances and are associated to facility. Staff have current first aid and training documentation showing training completed. Administrator's certificate was observed to be current. Resident Records : All five (05) resident records were reviewed. Residents’ records are complete and current at this time. Residents were also interviewed. No deficiencies cite during this visit. An exit interview was conducted and a copy of the report was provided.