Routine inspection·July 16, 2025

On July 16, 2025, Licensing Program Analyst (LPA) Deborah Lee conducted an unannounced annual required visit using the CARE Inspection Tool. LPA was met by Wilma Iglesias Assistant Administrator and the purpose of today's visit was explained. The facility is licensed to serve 6 elderly residents, all of which (6) may be non-ambulatory with a hospice waiver approved for two (2) aged 60+ years. The facility currently has 2 resident on hospice. Physical Plant/Structure: The facility is a 1-story structure with 5 bedrooms, 4 bathrooms, living room, kitchen and inside and outside patio. Bedrooms: LPA inspected all 5 bedrooms; the mattresses were in good condition, adequate lighting, plenty of dresser and closet space observed. Walls and floors were clean and in good condition. Comforters, bed linen, bath towels and mattress protectors were adequately stocked . Page 1 of 3 Bathroom s: Toilets and water faucets worked properly, grab bars were secure, and a non-skid mat was in place. Adequate lighting and toiletries accessible to residents. LPA tested hot water temperature, and it measured 106.6 degrees Fahrenheit. Common Rooms: All common areas are clean and free of obstructions. There is adequate seating for the residents in care. Each common area is equipped with furniture that is in good repair. Required Postings: LPA observed all required documents posted throughout the facility. The facility has a working landline telephone. Kitchen LPA observed a 2-day supply of perishable foods, and a 7-day supply of non-perishable foods properly stored, packaged, and labeled. Sharps were locked away and inaccessible to the residents. Safety LPA observed 2 fully charged fire extinguishers bought on 5/9/25. The last emergency drill was conducted on 5/16/25. First aid kid had all the required continents. File Review: LPA reviewed 4 resident files and found that ( 4 ) out of ( 4 ) had the required documents. LPA reviewed 4 staff files and found that ( 4 ) out ( 4 ) had the required documents, training, and certifications. Page 2 of 3 Medications LPA observed all centrally stored medications which were secured and locked. All medications were observed in their original packaging. LPA review 2 residents medication and MAR and found no discrepancies. Infection Control LPA observed required infection control signs posted throughout the facility. LPA observed a sanitizing stations in entryway of facility. LPA observed an ample supply of PPE supplies. Facility maintains General Liability Insurance which expires 6/30/26 No deficiencies cited during today's visit. Exit interview conducted, copy of report provided to Assistant Administrator Wilma Iglesias Page 3 of 3.