Routine inspection·October 1, 2025

At 10:45 AM, Licensing Program Analyst (LPA) Huma Rahimi arrived at the facility to conduct an unannounced annual inspection. Upon arrival, LPA was greeted by the staff Leo Macam and the Administrator was contacted via telephone. The Administrator Jozam Batuian. Arrived shortly after and LPA explained the purpose of the visit. LPA and Administrator conducted a physical plant tour and the following was observed: Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of 2-day perishable and 7-day non-perishable food at the facility; properly stored. Knives were stored in a locked cabinet in the kitchen. Medications : Medication and Medication Records were reviewed for proper documentation. LPA review of Centrally Stored Medication and Destruction Records (CSMDR) for residents and did not observe any discrepancies. Bedrooms: There are six (6) bedrooms of which four (4) are designated for residents' use. Three (3) of the bedrooms are currently occupied. One (1) room is currently vacant. Rooms occupied by residents were properly furnished with appropriate bedding and linens with sufficient lighting. A hallway closet by the bedroom was observed to store extra linens. Bathrooms: There are three (3) bathrooms. Two (2) are designated for residents' use. Bathrooms were properly supplied and had functional fixtures. Hot water temperature was noted at 106.2 degrees Fahrenheit. Continued on LIC809-C Common Areas : These included the living area and dining area. The common areas were properly furnished. The auditory alarms on all exit doors were on and functional at the time of the visit. The smoke alarms are dual carbon monoxide detectors they are hired wired and interconnected. Administrator tested smoke/carbon detectors at 11:00 a.m. and were observed to be functioning properly. The fire extinguisher is located in the kitchen and the laundry room with purchase date 07/16/2025. Surrounding Grounds : Entry/exits were free of obstruction. The outdoor area was free of hazards and has a covered patio with outdoor furniture. LPA observed a shed used for storage. The laundry room leads to the garage and is kept locked and inaccessible to residents in care. Detergents and cleaning products are kept in the laundry room locked. Between 11:15 AM to 12:15 PM, LPA reviewed records of three (3) residents and two (2) staff. Residents and staff records appeared to be complete and updated. Administrative: LPA collected Certificate of Liability Insurance, and LIC500. No deficiency issued during today’s visit. Exit interview conducted and copy of this report signed and delivered.