Routine inspection·March 3, 2025

On 3/3/2025 at 9:30am Licensing Program Analyst (LPA) Perchui Milena Khurshudyan arrived at this facility to conduct a required Annual Inspection. Upon arrival LPA was greeted by the Caregiver John Enriquez who granted access to the facility. LPA introduced herself by showing her badge and explained the reason for the visit. LPA Khurshudyan reviewed the required postings on a wall next to the entrance area. The Administrator arrived shortly after. The inspection tool was used to complete the visit. At 10:25am. LPA with the help of the caregiver began a physical plant tour of the facility and the following was observed: This is a single-story building with seven (7) bedrooms, of which 6 bedrooms are designated for residents’ private use and one bedroom designated for staff use only. There are five (5) bathrooms, kitchen, common areas: living and dining rooms, and outdoor areas. It has an approved fire clearance for six (6) Non-ambulatory residents, of which six (6) may be Bedridden. Facility also has Hospice waiver for six (6) residents. Common Areas : The facility maintains a comfortable temperature at 70°F. The living room and dining area appeared generally clean and were properly furnished. No obstructions and or tripping hazards throughout the facility was observed. Kitchen: At approximately 10:40am LPA toured the kitchen area and observed enough supplies of staple non-perishable for minimum 1 week and perishable for 2 days at the facility. LPA observed that cabinets containing chemicals were not locked and accessible to residents, sharps/knives and centrally stored medications were properly stored and locked inside the kitchen cabinet. There is a fire extinguisher on the kitchen wall which was last serviced on 08/12/2024. Bedrooms: There are seven (7) bedrooms designated for residents use and have sufficient lighting. All bedrooms are properly furnished, clean and have appropriate bedding and linens. Auditory alarms were tested and observed to be operational. Facility has awake staff. Continue on LIC809-C Bathrooms: At 10:50am LPA observed all bathrooms are clean and in good repair. Properly supplied with toilet papers, soap and paper towels. The hot water temperature measured at 115.8°F. LPA observed appropriate grab bar and non-skid mats. All trash cans in bathrooms had fitted lids to protect from cross contamination. Smoke detectors/carbon monoxide . Dual smoke and carbon monoxide detectors were located throughout the facility, and at 11:05am they were tested and observed to be operational. Outside areas: At approximately, 11:20am LPA toured the outside area of the facility and observed appropriate outdoor furniture, with a covered shaded area for residents LPA discussed the importance of maintaining the care and supervision to meet the needs of residents. There are no bodies of water. Laundry Room: Laundry machines are in a separate locked area outside of the facility. Disinfectants, laundry detergents and hygiene supplies were stored and inaccessible to residents in care. Garage: The garage is currently being used as an office space and storage. Between 11:45am to 12:40pm, LPA reviewed records of six (6) residents and four (4) staff members. Resident and staff records appeared to be complete and updated. MEDICATION: LPA observed centrally stored medication and First Aid kit locked in the kitchen cabinet and inaccessible to residents in care. LPA observed First-aid kit is complete and has new manual. Facility has Dementia Care Program. PRN medications have written orders from a physician. The facility serves residents with dementia and facility has trained staff to meet the needs of residents who are diagnosed with dementia. Facility has two (2) staff for AM shift and two (2) awake caregiver for PM shift. Administrative: Annual fee is current. All required signs are posted. LPA collected LIC500, LIC9020 and Certificate of Liability Insurance. The Administrator Certificate got renewed however still pending. One citation issued during this visit, please see LIC809-D. Exit interview conducted. Copy of report signed and delivered to the Licensee/Administrator.