Routine inspection·May 30, 2025

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced annual visit and was greeted by two caregivers. The Administrator, Rey Medel arrived at 11:00 am. The facility is licensed as an adult residential facility for the elderly to serve three ambulatory residents, three non-ambulatory which includes one bedridden resident. Staff confirmed there are five residents living in the facility. LPA and the Administrator began the tour of the facility at 10:15 am until 10:50 am. LPA observed the following: Living Room – LPA Spaeth observed the living room contained comfortable seating and a television. Kitchen/Dining room - The dining room and kitchen are combined. LPA Spaeth observed a seven-day supply of non-perishable food and a two-day supply of perishable foods. The fire extinguisher is located in the kitchen. LPA observed the knives were locked in a kitchen drawer, and the cleaning solutions were locked in a cabinet underneath the sink. A dining room table and chairs are located in the dining room area available for residents' use. Bathrooms – LPA Spaeth observed the bathrooms contained hand soap, grab bars, slip resistant mats, paper towels, and a trash can. Water Temperature - The water temperature was tested at 10:45 106.1 degrees F. Continued on 809-C Bedrooms – LPA Spaeth observed there are five residents' bedrooms in the facility. The bedrooms contained bed, linens, night stand, chair, chest of drawers, and a night lamp. Staff Room – LPA observed the staff room was locked. Laundry Room / Garage – LPA Spaeth observed the laundry room was locked. LPA observed the washer and dryer were located in the room. The laundry detergent was locked in a room within the laundry room. LPA observed an additional staff room was located in the garage area. LPA observed a deep freeze and two additional refrigerators which contained food. Hallway Closet – LPA Spaeth observed a hallway closet contained additional clean linens. LPA observed another locked closet which contained additional PPE and hygiene items. Backyard – LPA Spaeth observed comfortable seating in a shaded area. A locked gate surrounds the pool. The side gate leading from the backyard to the front yard was not locked. Smoke/Carbon Monoxide Detectors – The smoke/carbon monoxide detectors were tested at 10:55 am and are properly working. LPA reviewed resident's records at 11:00 am until 11:45 am. LPA reviewed the staff records at 11:45 am until 12:20 pm. Exit interview conducted and a copy of the signed report was given.