Routine inspection·September 19, 2025

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced visit on 9/19/2025 and was greeted by staff members Salik Charley and Mary Martin. LPA stated the purpose of the visit was to conduct an annual inspection. The staff confirmed there are five residents. The facility is licensed for six (6) non-ambulatory, bedridden residents. The Licensee Adrian Reyes arrived at 10:10 am LPA Spaeth and the caregiver toured the facility at 10:00 am until 10:30 am Common Areas – The living room and family room contained comfortable seating. A dining room table with chairs are located in the kitchen. The family room contained a television. Kitchen - LPA Spaeth observed a two day supply of perishable food and a seven day supply of non-perishable foods. The knives and cleaning solutions were locked in a cabinet. The fire extinguisher is located in the kitchen and is operable. Medication - LPA observed the resident medications and PPE supplies were safely locked in a kitchen cabinet. LPA observed the first aid kit. Resident Rooms: The resident rooms were furnished with a bed, linens, night stand, lamp and chair. The rooms were neat and clean. Continued 809-C Garage//Washer & Dryer – The laundry room contained the washer/dryer. The door leading to the garage was locked. Additional cleaning supplies and the laundry detergent were not securely locked. An additional refrigerator is located in the garage and contained additional food items. Staff Room: The staff room was not locked but there were no safety issues to report. Bathrooms: There are two (2) bathrooms in the facility. The bathrooms contained hand soap, paper towels, grab bars, and trash can. A slip resistant mat was missing in one of the bathrooms. LPA observed cleaning supplies were not safely locked in a cabinet. LPA observed the staff member removed the cleaning supplies and locked in a cabinet. At 11:15 am, a slip resistant mat was placed in the bathroom. Water Temperature: The water temperature was tested at 10:15 am and was 110 degrees F. Hallway Closet - LPA observed the clean linens were located in a cabinet. Surrounding Grounds : LPA observed the gate to the wooden fence on the side of the facility was broken. The Licensee confirmed the gate will be repaired. Smoke/Carbon Monoxide Detectors : The smoke and carbon monoxide detectors were tested at 10:20 am and were operable. LPA Spaeth reviewed the resident and staff files from 11:10 am until 12:15 pm. There were no issues with the resident and staff files. Based upon Title 22 Regulations, the following deficiencies are substantiated. (See 809-D page). Exit interview conducted, appeal rights discussed, and a copy of the signed report was given