Routine inspection·July 15, 2025

On 07/15/25 Licensing Program Analyst (LPA) Lorena Casillas conducted an unannounced one (1) year Required visit for this facility. LPA was greeted by Administrator Josephine Sanoy and informed of the purpose of the visit. A tour of the physical plant was conducted with the Administrator at 10:15 AM. The facility has four (4) bedrooms and two (2) bathrooms currently occupying three (3) residents. One (1) bedroom is designated for staff use only. The facility is Fire Cleared for three (3) non-ambulatory, one (1) bedridden, and a hospice waiver for one (1) resident. LPA observed two (2) residents watching T.V in the living room, one (1) was eating breakfast in the dining room. Infection control: The facility has an Infection Control Plan approved on 06/09/2022. Hand washing, coughing etiquette, physical distancing and other necessary signs were posted in the bathroom and all over the facility. Kitchen Area: At 10:20 am LPA conducted a tour of the kitchen and observed that there is sufficient stock of both two (2) day perishable and seven (7) day non-perishable food items. 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 locked and inaccessible to residents in care. The medication cabinet was also observed to be locked. Cleaning supplies and chemicals were observed to be locked in the storage room. Continued on LIC809-C Living and dining: At 10:30 am LPA observed the living room to be neat and clean along with the dining room. The facility maintains a comfortable temperature at 72°F. The smoke detectors and carbon monoxide detectors were tested and observed to be operational. There is a fire extinguisher located in the living room. The Fire extinguisher was observed to be full and last serviced 6/11/25. At 10:40 am smoke detectors and carbon monoxide detectors were tested and were operational. Garage/Laundry: At 10:45 am LPA observed the garage to be attached to the facility and is currently being used for storage. LPA observed a refrigerator and deep freezer in the garage. The Laundry room is located in the garage. All chemicals/hazardous items were observed to be locked in a cabinet. Resident Rooms: At 10:55 am LPA observed rooms to have the appropriate bedding. There is a nightstand and sufficient lighting for each resident. All alarms on the exit doors are functional. Bathrooms: At 11:10 am LPA observed all bathrooms to have the appropriate wash your hands signs posted, non-skid strips and handles. Hot water was tested and measured at 108.8 °F. Outside Area: At 11:20 am LPA observed a covered shaded area for residents. No bodies of water on the premises. LPA observed all tools in a locked gated area. Resident and Staff Files : LPA conducted a file review of staff and resident records at 12:00 pm. Interviews: At 01:30 pm LPA interviewed residents and staff. Administrative: LPA collected Certificate of Liability Insurance, resident roster, and LIC500. Annual fee is current. No citations issued. Exit interview conducted. Copy of this report was given to the Administrator.