Routine inspection·April 29, 2026

Licensing Program Analyst (LPA) Antonia Alvizar-Ettima conducted an annual required visit and inspection of the facility. LPA met with Caregiver and gained entry. The reason for this visit was explained. Caregiver contacted Administrator via telephone and joined the visit. At approximately 1:45p.m., LPA and Administrator conducted a physical plant tour. LPA observed required postings such as Long-Term Care Ombudsman, Emergency Disaster Plan, and Personal Rights located alongside the entrance hallway leading towards the kitchen. The facility is a single-story building with three (3) bedrooms and two (2) bathrooms currently occupying six (6) residents. The facility has an approved fire clearance for six (6) non-ambulatory residents of which one (1) may be bedridden. Dual Smoke and Carbon Monoxide detectors were tested and function properly. They are in each bedroom and hallway. Facility Emergency Fire/Earthquake Drills were conducted on 03/02/2026. The fire extinguisher is in the dining room with purchase date of 02/14/2026. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Common areas: The living room and dining room were observed to be neat, clean, and organized. The rooms were observed to be properly furnished and in good repair. The facility maintains a comfortable temperature at 74°F. A fireplace was observed to be covered and inaccessible to residents. A working telephone was observed. Kitchen: The kitchen appliances and fixtures were functional. The kitchen has a working gas stove, faucet, freezer, refrigerator, and microwave. LPA found at least two (2) days perishable and seven (7) days non-perishable food at the facility that is properly stored. Frozen foods are wrapped, Cont. on LIC 809-C Cont. from LIC 809 dated, and stored properly as well. Knives were stored in a locked cabinet in the kitchen. Food storage and preparation areas are clean and inaccessible to pests. Garbage cans have tight fitting covers. Cleaning supplies, pesticides or toxic cleaning supplies were stored and locked away in the kitchen cabinet. Bedrooms: The residents’ rooms are adequately furnished with appropriate furniture and lighting system. Hallways/passageways are lit appropriately. Extra linens/covers were observed stored in storage closet located near the entrance. Bathrooms: The bathrooms were checked for cleanliness and proper operation. The hot water temperature was measured within regulations at 118.1 °F. LPA observed there to be appropriate slip-resistant strips and grab-rails within the bathrooms, all in good repair. Washcloths are not shared. Laundry Service: There are enough linen in hallway closet available to change weekly or more if needed. Cleaning supplies are being stored in a locked cabinet in the attached garage. The garage is also used for PPE and extra food storage. First Aid Kit and Book: First aid kits have been inspected and have the following: thermometer, tweezers, scissors, antiseptic, bandages, gauze, first aid manual are updated and it's available for staff use but inaccessible for residents. Surrounding Grounds : Entry and exits were free of obstruction. There was furniture appropriate for outdoor use. The outdoor area was shaded and free of hazards. No bodies of water. Due to time constraints, LPA had to terminate the visit and will return on a later date to complete the Required - 1 Year inspection by reviewing medication, staff files, resident record, interviewing residents and complete the Compliance & Regulatory Enforcement (CARE) tools. No immediate health and safety hazard is noted during this visit. An exit interview was conducted. A copy of this report was provided to the Administrator.