Routine inspection·January 14, 2026

Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility. LPA was greeted by staff and disclosed the purpose of the visit. The administrator was contacted and arrived later. LPA conducted a tour of the physical plant at approximately 10:38 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 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 five (5) residents currently residing there. Two (2) days of perishable food observed. The freezer is stocked with meats and frozen vegetables. Sharps are stored in locked kitchen drawer. The resident medications and first aid kit stored in locked cabinet next to refrigerator and observed to be locked and inaccessible to residents. There is one (1) fire extinguisher attached to kitchen wall and observed to be charged. Laundry room is located in walk through next to kitchen The appliances observed to be functional. Toxins stored in locked floor cabinet next to dryer and was observed to be locked and inaccessible to residents. The facility has a total of five (5) bedrooms and two (2) bathrooms: one (1) bedroom 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 had the following items available: hand soap, paper towels, and trash cans. The hot water temperature was measured in bathrooms to ensure it was within the required range for residents’ comfort and safety. The water temperature range was measured at 117.7 and 120.5-degrees Fahrenheit for main bathroom shower. Backyard has the following: (1) one patio table, umbrella with seating. Patio furniture observed to be in good repair. Detached Garage: Used for storage of equipment and furniture. There is no body of water in the facility. Storage shed used for storage in backyard observed to be locked and inaccessible to residents. Smoke detectors/carbon monoxide detector were tested and operable at time of visit. Facility grounds were free of hazards At approximately 11:30 am, LPA Smith reviewed files for the five(5) residents and three (3) staff. One staff file not available for review. Additional visit may be required for follow-up to included but not limited to: hospice admissions, fire clearance, and prohibited health condition. Deficiencies cited on 809D Exit Interview Conducted / A Copy of the Report Issued