Routine inspection·June 12, 2025

At 9:50 AM, Licensing Program Analyst (LPA) Huma Rahimi conducted an unannounced annual inspection. LPA met with the staff Dell Morales AKA Delinia Morales and the the Administrator was contacted via telephone. LPA explained the reason for the visit. Administrator arrived at the facility shortly after. LPA and Administrator toured the facility inside and out. The facility is a single story building with seven (7) bedrooms, four (4) bathrooms, kitchen, dining room, office, garage, storage areas, common areas, and outdoor areas. It has an approved fire clearance for six (6) non-ambulatory residents, of which one (1) may be bedridden. The facility serves residents with dementia. Hospice waivers approved for two (2) residents. Kitchen: At 10:00 AM, LPA observed that the kitchen contained a freezer, a refrigerator, and two pantries. LPA observed an adequate supply of perishable and non-perishable food. Sharp objects were locked near the stove. Cleaning solutions were locked in a cabinet next to the kitchen. Medications: Medications were locked near the kitchen in a cabinet and inaccessible to residents in care. Bedrooms: The facility has seven (7) private bedrooms. One (1) bedroom is designated as a staff room. All bedrooms contained a chair, nightstand, lamp, storage, and bed with clean and appropriate bedding. LPA observed that a resident in room #5 requires incontinence care and a staff approached to change the resident; however, the resident denied to be changed. The Administrator informed LPA that an incident report for the refusal will be submitted to Community Care Licensing Division (CCLD) accordingly. Continue on LIC 809C Bathrooms: The facility has four (4) bathrooms. All bathrooms contained liquid soap, paper towels, handwashing instruction sign, trash can with a tight fitting lid, grab bars near the toilet and shower, and a non-skid mat in the shower. At 10:15 AM, LPA measured the water temperature in the shared bathroom to be 117.5 degrees Fahrenheit. Garage: The garage was locked from the outside. It contained a washer, dryer, paper supplies, extra water bottles, and detergents. Common Areas: Walls, floors, ceilings, windows, screens, and blinds were clean and in good repair. At 10:20 AM. LPA measured the living room temperature to be 75 degrees Fahrenheit. Extra linens were kept in a storage closet in the hallway between bedroom #1 and bedroom #6. Safety: At 10:30 AM, LPA observed a fully charged fire extinguisher in the kitchen and was purchased on 12/19/2024. In the backyard of the facility LPA observed personal belongings of a resident who exited the facility as of 05/22/2025. The Administrator is safeguarding the personal belongings of the former resident until he/she comes back from their vacation to remove the items. Administrator agreed to submit a plan to LPA of how to securely safeguard the personal belongings of the former resident. All emergency exit paths were free from obstructions. Exit gates were unlocked. At 10:35 AM, LPA tested four (4) out of four (4) smoke detectors to be operational. Smoke detectors were hard wired. LPA tested the carbon monoxide detector to be operational. LPA heard four (4) out of four (4) auditory alarms on and functioning during visit. Between 12:10 PM to 1:15 PM, LPA reviewed records of four (4) residents and two (2) staff. Residents and staff records appeared to be complete and updated. Administrative: LPA collected Certificate of Liability Insurance, and LIC500. No deficiencies issued during today’s visit. Exit interview conducted and copy of this report signed and delivered.