Routine inspection·April 15, 2026

At 1:15pm Licensing Program Analyst (LPA), Angela Panushkina, conducted an unannounced annual inspection at the facility mentioned above. LPA met with the Administrator and explained the reason for the visit. At 1:20am, LPA conducted a tour of the facility and the following was observed: Facility is approved for six (6) Non-ambulatory, of which six (6) may be Bedridden. Facility also has a hospice waiver granted for six (6) residents. The facility maintains a comfortable temperature at 71°F. Kitchen: At approximately, 1:25pm LPA toured the kitchen area and observed enough supplies of staple non-perishable for minimum 1 week and perishable for 2 days at the facility. All knives and sharps are observed to be locked in a kitchen drawer and inaccessible to residents. There is a fire extinguisher by the kitchen area and it was last serviced on 02/19/2026. Medications: At approximately, 1:30am LPA observed medications are centrally stored and locked in the kitchen cabinet and inaccessible to residents in care. The first-aid kit has been inspected which has at least the following: tweezers, scissors, antiseptic, bandages, gauze, thermometer; including a current First Aid manual. Bedrooms: There are six (6) bedrooms designated for residents use and have sufficient lighting. All bedrooms are properly furnished, clean and have appropriate bedding and linens. Auditory alarms were tested and observed to be operational. Facility has awake staff at night. Continue on LIC809-C Bathrooms: The facility has three (3) and 1/2 (half) bathrooms. LPA observed all bathrooms have non-skid mat, soap, paper towels and hand washing signs. Extra towels and linens were readily available. The hot water temperature measured at 120°F Common Areas : These include a dining area and a living room. The common areas are furnished with adequate furniture to accommodate a maximum capacity of six (6) residents. D ual smoke and carbon monoxide detectors were located throughout the facility, and at 1:40pm they were tested and observed to be operational. Laundry: Laundry area is located by the garage and LPA observed it to be locked and inaccessible to residents in care. There were no visible immediate hazards. Outside areas: At approximately, 1:45pm LPA toured the outside area of the facility. LPA also observed a clean covered patio and backyard furniture to accommodate the six (6) residents . There is a swimming pool that is fenced all around with a gate that will be kept locked at all times. The fence surrounding the swimming pool is approximately 5 feet high all around. You will need a key to gain entry to the swimming pool as it is kept locked at all times. Between 1:50pm to 2:30pm, LPA reviewed records of five (5) residents and two (2) staff. Resident and staff records appeared to be complete and updated. LPA collected Certificate of Liability Insurance and LIC500. No citations were issued during this visit. Exit interview conducted and copy of this report signed and delivered.