Routine inspection·June 23, 2021

Licensing Program Analyst (LPA) Kruz Long conducted a site visit for the annual inspection. Upon arriving at the facility, LPA met with Maryanne Vergara and explained the purpose of the visit. The facility is licensed to serve elderly residents age 60 and above. Facility fired cleared for two (2) ambulatory and four (4) non-ambulatory residents age 60 and above. Approved to accept or retain one (1) resident on hospice. The facility is located in a residential area. A tour of the single-story facility includes: Living room, sun room, family room, kitchen, dining room, 5 resident bedrooms, 1 staff room, office area, laundry area and 3 bathrooms. The bathrooms are clean and operational. Resident bedrooms were checked and closet/drawer space to accommodate each resident comfortably was available. The hot water temperature tested at 110 degree F in bathroom #3. The kitchen was observed for the ability to prepare and serve food. LPA observed an appropriate food supply of two (2) days of perishables and one week (7 days) of non-perishables. All storage areas for cleaning solutions, toxins, knives, and hazardous items are in a secured cabinet and inaccessible to residents. Smoke detectors and carbon monoxide detectors are operable and in compliance. The fire extinguisher was observed in the kitchen area and was fully charged. The first-aid kit is fully stocked w/First-aid Manual. A shaded area with chairs is provided in the back yard. The backyard is free of debris/hazards and the outdoor and passageways are free of obstruction. There is a fenced pool in the backyard. Freezers and refrigerators are clean, and maintain temperatures. Sufficient staff as necessary to ensure provision of care and supervision to meet resident needs were observed. LPA was allowed to enter the facility to conduct the inspection. All medications are labeled and maintained in compliance with label instructions and State and Federal law. Medications are safe, locked and inaccessible. No deficiencies were observed during today's visit. An exit interview was conducted and a copy of this report was provided to Maryanne Vergara.