Routine inspection·August 5, 2025

Licensing Program Analyst (LPA), Tihesha Smith conducted an unannounced Required 1-year inspection at this facility at 09:45 am. LPA met with staff, and the administrator was contacted and arrived later. LPA conducted a tour of the physical plant at approximately to ensure there are no health and safety hazards, and the facility is following Title 22 Regulations. Common areas—including the combined living and dining room, as well as the kitchen were evaluated for their ability to safely meet residents' needs. These spaces were inspected for cleanliness, and furniture was assessed for functionality and condition. All common areas were found to be clean, sanitary, and furnished with seating sufficient to accommodate residents comfortably. LPA reviewed the food service areas, food storage and supply (perishable and nonperishable foods). The kitchen food supply was observed and sufficient for the four (4) residents currently residing there. Two (2) days of perishable food observed. The freezer is stocked with frozen foods to include meats and vegetables. There are two (2) extra refrigerator/Freezers (one in back yard storage/one in front yard storage) both stocked with back stock foods. Resident medications are stored in the upper kitchen cabinet. Medications observed to be locked and inaccessible to residents in care. The sharps are stored in a locked kitchen drawer and inaccessible to residents. Toxins are stored and locked under the kitchen sink. Outdoor laundry area appliances were observed to be functional.One (1) fire extinguisher attached to the wall in the kitchen observed to be charged. (Cont. from 9099) The facility has a total of three (3) bedrooms for residents and two (2) bathrooms for residents’ use. 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 hygiene and incontinence supply in hallway closets. Each bathroom has the following items available: hand soap, paper towels, and trash cans. The hot water temperature set for the bathrooms and facility at 120.0 degrees Backyard: Patio furniture observed to be in good repair. There are two (2) sheds used for storage and extra food replenishment. Garage: no garage at the facility. Smoke detectors and Carbon Monoxide detectors were tested and operable at the time of visit. Facility grounds were free of hazards. There is no body of water in the facility. At approximately 10:55 am, LPA reviewed facility records. The Administrator has a current license to include CPR/First aid. Resident records have admissions agreements, Pre appraisal and physician reports. At the time of the visit staff did not have first aid/CPR. The administrator was informed that at least one (1) staff at facility must have a valid CPR/First aid certificate/item corrected later same day. Citation issued on 809D. Exit Interview Conducted / A Copy of the Report given