Routine inspection·August 12, 2025

Licensing Program Analyst (LPA) Evelin Rios arrived at the facility above to conduct an unannounced annual required visit. LPA rang the door bell and was contacted by the administrator. LPA explained the reason for the visit. Administrator stated they were out in the community running errands and well meet LPA at the facility. LPA was greeted and granted access by staff #1(S1). At approximately 10:20 am., LPA initiated the physical plant tour of the facility inside and out. The following was observed. LPA observed a sign in log for visitors by the entrance and required postings on a bulletin board by the dining table. Kitchen: LPA conducted a tour of the kitchen at 10:25 a.m, and observed there to be sufficient amount of two-day perishables and seven-day non-perishables food. LPA also observed a deep freezer. Food storage and preparation areas were clear of clutter. LPA observed all knives and sharps locked and inaccessible to residents in care. The Medication cabinet was in the kitchen and was observed to be locked. LPA observed a fire extinguisher by the kitchen to be fully charged. Bedrooms: There are three (3) bedrooms for residents' use. Bedrooms may be shared. Bedrooms were observed to be properly furnished with appropriate furniture, bedding and sufficient lighting. LPA observed extra linens in residents' closets. Bathrooms: There are two (2) bathrooms for residents. One (1) bathroom is located in a shared bedroom for private use. Bathrooms were properly supplied with toilet paper, paper towels, hand soap, nonskid matts and grab bars. Hot water temperature was measured at 10:45 a.m., and read 116.2 degrees Fahrenheit. Common Areas: LPA observed the living areas and the dining areas to be neat and clean. At 12:14 p.m., the administrator tested the dual smoke detectors and carbon monoxide detectors and they were observed to be operational. Laundry/Garage: LPA observed a washer and dryer in the garage. The garage is attached and accessible through one of two doors. Detergent and cleaning supplies are kept locked in a cabinet in the garage. Surrounding Grounds: LPA toured the outside area of the facility. LPA observed appropriate outdoor furniture, with an outdoor umbrella for shade . No bodies of water observed. Entry/exits were free of obstruction. Administrative: LPA reviewed facility's , Infection Control Plan, liability insurance and Emergency Disaster Plan (LIC610E). Resident and Staff Files : At approximately 11:15 a.m., LPA conducted a file review of four (4) out four (4) resident records and three (03) staff files to insure compliance of licensing forms. Medications : Centrally Stored Medication and Medication Records were reviewed for proper documentation. LPA observed a first aid kit fully stocked on the refrigerator. No deficiencies cited. Exit interview was conducted. A copy of report provided.