Routine inspection·June 3, 2025

At 09:30am, Licensing Program Analyst (LPA) Angela Panushkina arrived at the facility to conduct an unannounced annual inspection. Upon arrival, LPA met with Staff #1 (S1) who granted access to the facility. The Administrator arrived shortly after, and LPA explained the reason for the visit. Today's site visit consisted of LPA touring the physical plant inside and outside and observed the following: Facility maintains a temperature of 71°F. Facility is licensed for capacity of six (6) of which six (6) non-ambulatory and one (1) bedridden resident. There are four (4) bedrooms designated for resident’s use, and one staff room (room #1). LPA observed all bedrooms to be appropriately furnished with a bed, night stand, a chair, extra linens and have appropriate lighting. The facility also has three (3) bathrooms. LPA observed all bathrooms have soap, paper towels and extra towels and linens were readily available. The hot water temperature measured at 120.0°F. At 09:40am, LPA observed medications, residents and staff files are kept in the hallway closet and observed to be locked and inaccessible to residents in care. There is a complete first-aid kit in the cabinet with all required supplies and with the first aid manual. The fire extinguisher is located in the dining room and was last purchased on 04/29/2025. LPA observed there to be sufficient stock of one-week perishable foods and two-day non-perishable foods. Frozen foods are properly wrapped and stored appropriately. Food storage and preparation areas are clean and inaccessible to pests. Continue on LIC809-C Laundry is located by the garage. The washer/dryer appear to be in good condition. All chemicals and detergents are kept inaccessible to residents in care. Smoke detectors and carbon monoxide monitors were tested and observed to be functional. The back of the facility has sufficient yard space. At 10:05am, LPA observed appropriate outdoor furniture, with a covered shaded area for residents. There is a swimming pool that is fenced all around with a gate that is approximately 5 feet high. You will need a key to gain entry to the swimming pool as it is kept locked at all times. LPA discussed the importance of maintaining the care and supervision to meet the needs of residents. Between 10:15am to 11:15am, LPA reviewed records of five (5) residents and three (3) staff. Resident and staff records appeared to be complete and updated. LPA observed Administrator certificate renewed on 05/9/2025. Annual fee is paid in full. LPA collected Certificate of Liability Insurance and LIC500. No citations issued during this visit. Exit interview conducted and copy of this report signed and delivered.