Routine inspection·August 26, 2025

On 8/26/2025 at approximately 09:30 AM, Licensing Program Analyst (LPA), Angelica Segovia conducted an unannounced annual visit to the facility. LPA was greeted by the caregiver and stated the reason for their visit. The Administrator, Jojomaureli Salamero arrived shortly after to assist with today’s visit. LPA asked for the census, Staff/Resident Roster, and Liability Insurance. LPA conducted a physical plant tour at approximately 12:00 PM and the following was noted: The facility is a single-story building with five (5) bedrooms and two (2) bathrooms. The facility is currently occupying three (3) residents. There is a designated staff room. The facility has an approved fire clearance for five (5) non-ambulatory residents of which one (1) may be bedridden. Hospice waiver approved for four (4). (Continue to LIC 809-C) The following deficiencies were observed: - The only staff member present upon LPA’s arrival did not have proof of First-Aid/CPR training, initial training and dementia training - The Administrator’s certificate expired: 7/05/2024 - All four staff documentation were missing and/or incomplete - 1 of 3 residents were missing a pre-appraisal - All 3 residents missing Needs and Service Plans - 1 of 3 residents requires awake staff due to wandering behavior documented on their Physician’s Report - In the backyard LPA observed an accessible storage unit unlocked containing multiple cans of paint and toxins Due to time constraints, the yearly annual will need to be completed at a later date. Citations will be issued at later date. Exit interview conducted and a copy of this report was provided to the Administrator.