Routine inspection·April 14, 2025

Licensing Program Analyst (LPA) Mariana Agban conducted an Annual Required visit and inspection of the facility. LPA met with staff Carlo Magcalas and explained the reason for the visit. Shortly after, LPA met with Administrator Mercer Jones. At approximately 10:40 am, with the assistance of staff, LPA took a tour of the physical plant, facility temp at 75 degrees. Required postings were observed in the entry area. The smoke alarms and carbon monoxide are properly functional. The fire extinguisher is located in the kitchen with date of purchase 08/22/2024. Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives were stored in a locked drawer in the kitchen. Properly labeled medications were locked in one of the kitchen cabinets. Bedrooms: The facility has five (5) bedrooms total. There were four(4) bedrooms designated for residents' use. One(1) bedroom is designated for staff. All bedrooms, in use by residents, were properly furnished with appropriate beddings and linens with sufficient lighting. Bathrooms: There are five (5) bathrooms designated for residents' use. All bathrooms were properly supplied and had functional fixtures. Water temperature in the bathrooms measured between 105-109 degrees F. No cleaning supplies were observed in the bathrooms during inspection. Common Areas : These included the living room and dining area. The common areas were properly furnished. Surrounding Grounds : Entry/exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was free of hazards.The gates at both sides of the home were checked to ensure no locks were installed, and that exits and passageways were clear for emergency evacuation. (Continue on 809C) Garage/ Laundry Area : The garage is attached to the building. The garage is used as storage. There is also a freezer for additional perishable food items. Entry to the garage from inside the home is located by the kitchen. LPA observed the washer and dryer to be in good repairs. No cleaning supplies or toxin stored in the garage at the time of the visit. Resident Files : LPA conducted a file review of resident records to ensure compliance of licensing forms. Staff Workstation/Office : There is a staff office located in the living room, where staff records are kept and locked in a filing cabinet. Staff Files : LPA also conducted a file review of staff records to ensure forms are in compliance. During records review LPA observed S3 has no physical file at the facility. In addition LPA observed that S2 has expired First Aid/CPR certificate. Administrator stated that all required documents will emailed to LPA Agban promptly. Medications : Medication and Medication Records were review for proper documentation. Exit interview conducted, citations issued, appeal rights given and copy of this report signed and delivered. .