Routine inspection·July 10, 2025

On July 10, 2025, Licensing Program Analyst (LPA) Deborah Lee conducted an unannounced annual required visit using the CARE Inspection Tool. LPA was met by Jun Fausto Figueroa, Administrator and the purpose of today's visit was explained. The facility is licensed to operate for 6 elderly adults ages 60 and above (4 non-ambulatory and 2 ambulatory). There is an approved hospice waiver for (4). Current facility census is 4 (3 non-ambulatory and 1 ambulatory). Facility fees are current. Physical Plant/Structure : The facility is a single-story structure located in a residential neighborhood and consists of the following: (4) resident bedrooms, (2) resident bathrooms, living room, dining room, family room, kitchen, office area, a laundry area, de- attached garage used for storage, and backyard with table and chairs. Bedrooms: LPA inspected all 4 bedrooms; the mattresses were in good condition, adequate lighting, plenty of dresser and closet space observed. Walls and floors were clean and in good condition. Comforters, bed linen, bath towels and mattress protectors were adequately stocked. Page 1 of 2 Bathroom s: Toilets and water faucets worked properly, grab bars were secure, and a non-skid mat was in place. Adequate lighting and toiletries accessible to residents. LPA tested hot water temperature, and it measured 105.7 degrees Fahrenheit. Common Rooms: All common areas are clean and free of obstructions. There is adequate seating for the residents in care. Each common area is equipped with furniture that is in good repair. Required Postings: LPA observed all required documents posted throughout the facility. The facility has a working landline telephone. Kitchen LPA observed a 2-day supply of perishable foods, and a 7-day supply of non-perishable foods properly stored, packaged, and labeled. Sharps were locked away and inaccessible to the residents. Safety LPA observed 1 fully charged fire extinguishers last serviced on 6/25/2025. The last emergency drill was conducted on 4/18/25 . First aid kid had all required items. Due to time restraint, LPA to continue inspection on subsequent visit. There were no citations issued during this visit. Exit interview conducted with Jun Fausto Figueroa, Administrator and copy of report provided. Page 2 of 2