Routine inspection·March 11, 2026

Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility 9:47 am. LPA disclosed to the administrator the purpose of the visit. LPA conducted a tour of the physical plant at approximately 10:20 am to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. Common areas were observed for the ability to safely serve the needs of residents. These included the kitchen/dining room combination, living room and family room. The common areas were checked for cleanliness and furniture was checked for functionality. Common areas observed to be furnished appropriately with adequate seating for residents. LPA reviewed the food service areas, food storage and supply (perishable and nonperishable foods). The kitchen food supply was observed and sufficient for the six (6) residents currently residing there. Two (2) days of perishable food observed. The freezer is stocked with meats and frozen vegetables. Emergency food pantry in hall closet. Sharps are stored in locked bottom kitchen cabinet. The resident medications were stored in locked top kitchen cabinet and observed to be inaccessible to residents. The first aid kit on top of refrigerator. There is one (1) fire extinguisher attached to wall in the kitchen and observed to be charged. Laundry room is located adjacent to kitchen. The appliances observed to be functional. Toxins stored above in locked cabinet above washer and dryer were observed to be locked and inaccessible to residents. The facility has a total of five (5) bedrooms and four (4) bathrooms: One (1) shared and four (4) private bedrooms; three (3) bathrooms for residents use and one (1) bathroom for staff. The residents’ bedrooms were properly furnished with at least one chair, nightstand, and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets. LPA observed a supply of linens in hall closet. Each bathroom has posted “wash your hands” signs and the following items available: hand soap, paper towels, and trash cans. The hot water temperature was measured for the three (3) bathrooms to ensure it is within the required range for residents’ comfort and safety. The water temperature range was between 108-118 degrees Fahrenheit. Detached Garage: Used for storage and has 2 nd refrigerator. Smoke detectors/carbon monoxide detector were tested and operable at time of visit. Backyard has the following: Gazebo with sufficient seating for the residents. Foliage in backyard overgrown presents tripping hazard. Discussion of painting vs cleaning discussed due to excessive peeling on cabinets in hallway. At approximately 11:30 am, LPA reviewed files for the six (6) residing residents. Resident files included medical assessments and needs and services plans. Staff files reviewed for three (3) staff. Staff files had the appropriate trainings such as first aid and hospice in session training. Deficiencies on cited 809D. Exit Interview Conducted / A Copy of the Report Issued.