Routine inspection (multi-day)·October 9, 2025

On 10/09/25, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced required – annual continuation inspection and met with House Manager Angelito Costa. The facility is licensed to serve six (6) non-ambulatory residents, in which six (6) may be bedridden. The facility has a hospice waiver approved for one terminally ill resident. The facility is a one-story house located in a residential neighborhood and consists of four (4) resident bedrooms, one (1) staff bedroom, three (3) bathrooms, kitchen, living room, family room, shaded patio and an attached garage. The facility is clean, sanitary, and in good repair. Annual fees are current. The House Manager accompanied LPA inside and outside the facility during this inspection. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. There are no security bars or weapons on the premises. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew, a non-skid mat was in place, and water temperature measured at 114.5 degrees Fahrenheit. Continue to LIC809-C. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards and doorways were free of obstruction. LPA toured the kitchen area and observed a two-day supply of perishable and a seven-day supply of non-perishable food. Knives and toxins were kept in locked storage cabinet. First Aid kit was available. One fire extinguisher, purchase September 11, 2025 was observed near the front door. House Manager tested the carbon monoxide detector and smoke detectors in the house. Both devices were functional. Fire Prevention Inspection was conducted on February 18, 2025. Five (5) staff records were reviewed and, five (5) out of five (5) staff records had required criminal record clearances or criminal record exemptions and first aid certificates. Three (3) resident records were reviewed and, three (3) out of three (3) resident records had medical assessments and pre-appraisal or reappraisals. Two residents’ medication was reviewed. No deficiencies are being cited. An exit interview was conducted, technical assistance provided, and a copy of this report was discussed and left with the House Manager Angelito Costa.