Routine inspection·May 8, 2025

On 04/08/25, Licensing Program Analyst (LPA) Mario Leon conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with staff one, Leia Joaquin Administrator (S1). LPA explained the purpose of today’s visit. The facility is licensed to serve (6) residents ages 60 and above. Of which (4) may be non-ambulatory and (2) bedridden. Approved hospice waiver for (1). Currently the facility has four (4) residents in care. The facility is a single-story structure located in a residential neighborhood. Disability ramps are located at the front door and back door for the ease of relocation of residents considered "non-ambulatory". It consists of (7) bedrooms, (2) full bathrooms, shaded back yard, front yard and an attached 2 car garage which contains a clothes washer and dryer. LPA toured the physical plant with staff. There were no bodies of water or obstructions on the premises. A total of seven (7) rooms and two (2) bathrooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided in each room and storage for the residents’ personal belongings was observed, larger than 8 cubic feet. Bathrooms were observed and no mold or mildew was observed and were within title 22 regulations. LPA inspected the smoke/carbon monoxide detectors and all were in operable condition. The water temperature measured between 105F° and 120F° , w hich indicates the water utility is within title 22 regulations. LPA observed the interior of the facility to be generally clean, sanitary, and appropriately furnished at the time of the visit. LPA observed Room #3 has cobwebs, living room has cobwebs (above room #1), this deficiency was corrected on site, please see LIC9102-TA. While LPA conducted an outside tour of facility, LPA observed two (2) wasp nests in the backyard One (1) nest is above the window to room two (#2), another nest is above the window to room three (#3). Please see LIC809-D. Storage areas for personal hygiene were observed. Sharp objects were locked and inaccessible to residents in care. Evaluation Report Continues, see LIC809-C A review of (3) residents' service files, (3) staff personnel files were checked. (3) Medication Administration Records (MAR) were reviewed. LPA observed resident four (R4) are missing Physician/Mental/Dentist emergency contact, please see LIC809-D. Two (2) deficiencies have been cited, please see LIC809-D. Two (2) Technical assistance notes have been provided, see LIC9102-AN. An exit interview was held with Leia Joaquin, Administrator (S1) and a copy of this report, appeal rights and deficiencies have been provided.