Routine inspection·April 8, 2026

At 11:45am, Licensing Program Analysts (LPAs), Angela Panushkina and Huma Rahimi conducted an unannounced annual inspection at the facility mentioned above. LPAs met with the Administrator and explained the reason for the visit. Facility is licensed for capacity of six (6) Non-Ambulatory, of which one (1) may be Bedridden in room #1 only. Hospice waiver is granted for two (2) residents. At approximately 12:00pm, LPAs toured the kitchen area and observed enough supplies of staple non-perishable for minimum 1 week and perishable for 2 days at the facility. All knives and sharps are observed to be locked in a kitchen drawer and inaccessible to residents. There is a fire extinguisher in the kitchen was fully charged. LPAs observed five (5) bedrooms designated for residents’ use. All bedrooms have sufficient lighting, properly furnished, clean and have appropriate bedding and linens. Auditory alarms were tested and observed to be operational. Facility also has awake staff at night. There are two (2) full bathrooms. All bathrooms were observed to be clean and in good repair. Properly supplied with toilet paper, soap and paper towels. The hot water temperature measured at 105.8°F. LPAs observed appropriate grab bar and non-skid mat. All trash cans in bathrooms had fitted lids to protect them from cross contamination. The facility maintains a comfortable temperature at 75°F. The Common areas are furnished with adequate furniture to accommodate a maximum capacity of six (6) residents. Continue on LIC809-C At approximately 12:30pm, LPAs observed medications are centrally stored and locked in the kitchen cabinet, and inaccessible to residents in care. The first-aid kit has been inspected which has at least the following: tweezers, scissors, antiseptic, bandages, gauze, thermometer; including a current First Aid manual. The laundry is located by the kitchen. The washer/dryer appears to be in good condition. Laundry supplies are kept inaccessible when not in use with supervision. At 12:50pm, smoke and carbon monoxide detectors were tested and observed to be operable. At 1:00pm, LPAs toured the outside area of the facility. LPAs observed appropriate outdoor furniture, with a covered shaded area for residents. The outdoor area was free of visible immediate hazards. LPAs discussed the importance of maintaining care and supervision to meet the needs of residents. Between 1:10pm to 2:00pm, LPAs reviewed records of five (5) residents and two (2) staff. Client and staff records appeared to be complete and updated. LPAs were informed that no Certificate of Liability Insurance is available at this time and will be provided to the department within two (2) weeks. Deficiency issued during this visit. Exit interview conducted and copy of this report signed.