Routine inspection·May 29, 2025

On 05/29/2025 Licensing Program Analyst (LPA) Evelin Rios conducted an Annual Required visit and inspection of the facility. The inspection tool was used for todays visit. LPA met with Staff#1 (S1) who granted access and contacted the Administrator, Augustine Kehinde. LPA met the administrator shortly after and explained the reason for the visit. Physical tour was conducted and LPA observed the following: At entry LPA observed appropriate postings on the wall near the front door and the hallway leading to residents bedrooms and bathroom. Kitchen: At 11:32 AM, LPA observed S1 washing dishes. The kitchen appliances and fixtures were functional. LPA also observed enough 7 day non-perishable amount of food and a 2 day perishable supply of food in the facility. Staff #2 (S2) arrived to the facility at 11:39 a.m., with more groceries. Bedrooms: There are four (04) resident bedrooms in total. Two (02) bedrooms are shared and two (02) bedrooms are for private use. Resident bedrooms were observed clean and clear of clutter, properly furnished with appropriate beds, night stands and chairs. Doors in bedrooms leading to the outside had auditory alarms that were observed functional. In the hallway closet leading to bedrooms labeled 2 and 3 LPA observed extra bed and bath linens. Bathrooms: There are three (03) bathrooms designated for residents' use. Bathrooms were properly supplied and had functional fixtures. From 12:27 p.m. to 12:30 p.m. LPA took the hot water temperature from two (02) out of three (03) bathroom and they measured between 110.1 and 119.1 degrees Fahrenheit, within regulation. ( Continue on LIC809-C) Common Areas : These included two (02) living rooms, and the dining area. The common areas were properly furnished. The dining room has a table with chairs to sit the capacity of the facility. The living rooms have televisions and couches that were observed in good repair. Outside/Surrounding Grounds : LPA observed that the entry/exits were free of obstruction. There is a shaded area for residents to use and furniture appropriate for outdoor use. The backyard is sufficient in space for outdoor exercise and activities. No bodies of water observed. Laundry/Garage: The laundry area is located in the attached garage. there is access to the garage inside the facility. The door leading to the garage was observed locked. Cleaning supplies and detergents are kept locked in the garage. The garage is used for facility storage. STAFF WORKSTATION: Facility has a work station for staff. The work station is located by the dining area. Facility files and resident records are stored in a locked cabinet in the workstation. Medications are stored in a locked cabinet in the work station. A first aid kit is kept in the locked cabinet with the medications. Smoke detectors/carbon monoxide . All resident rooms are equipped with smoke detectors and the facility's smoke detectors are hard wired and interconnected. There is a pull station located at the front entrance. The carbon monoxide detector is located in the hallway. Detectors were tested by administrator at 1:17 p.m., and were observed operational. The fire extinguishers are located by the entry and in the kitchen. They were observed fully charged with service date 04/21/25. From 1:20 p.m. to 2:30 p.m., LPA reviewed six (06) of six (06) resident records and (3) staff records. Records were observed locked in a workstation cabinet, complete and up-to-date. At 2:31 p.m., LPA reviewed resid ent s' centrally stored medication and medication records. LPA observed medications are centrally stored and locked in the work station cabinet. LPA collected a copy of the Certificate of Liability Insurance, and LIC500. LPA reviewed administrator certificate, LIC610E, and last Fire Drill training conducted on 02/22/2025. No deficiency cited during today’s visit. Exit interview conducted and copy of this report signed and provided