Routine inspection·November 17, 2025

Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced annual inspection visit on 11/17/2025 and was greeted by Caregiver Celina Vasquez. LPA Ramirez identified herself and explained the purpose of the visit. The facility is located on a main street and is a single-story dwelling. LPA utilized the Compliance and Regulatory Enforcement (CARE) tools for the visit today and observed the following: Physical Plant and Environment safety: Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to residents, were observed to be inaccessible to residents. LPA Ramirez observed carbon monoxide detectors and smoke alarms in hallways. LPA Ramirez inspected fourteen (14) resident rooms. All resident bedrooms contained required furniture, linens and lighting. LPA Ramirez observed sufficient lighting in rooms#1 & #2 however, LPA Ramirez observed ceiling lights bulbs in bedroom#1 & #2 were not operational. LPA Ramirez will issue a Technical Violation based on this observation. Water temperatures in all grooming and bathing areas were not measured to be within 105 – 120 degrees F. LPA Ramirez tested water temperature in resident bathroom#1 to be 136.6 F degrees. Resident room#2-bathroom water temperature tested at 133.5 F degrees during inspection. LPA Ramirez will issue Type A violation. LPA Ramirez observed grab bars near toilets and inside shower. LPA Ramirez observed no-slip coating in showers. LPA Ramirez observed seated shower chairs in bathrooms. Planned Activities: LPA Ramirez observed board games, magazines, and other activities for residents. Residents Rights-Information: LPA Ramirez observed the following postings in common areas throughout the facility: Complaint Poster (PUB 475), personal rights, and nondiscrimination notice. LPA Ramirez observed facility land line. See 809-C Food Service: LPA Ramirez observed sufficient supply of nonperishable for one week and perishable foods for a minimum of two days in the facility kitchen area. Soaps, detergents, and cleaning compounds were observed to be stored away from food supplies. Freezers and refrigerators were observed to be clean and within temperatures of 0-degree F (-17.7 degree C), and refrigerators with maximum temperature of 40-degree F. (4 degree C). Water temperature in kitchen area was tested above 125 F degrees. Residents are not allowed in this area. LPA Ramirez will issue Technical Violation based on this observation. Commercial fridge located in kitchen was observed to be in disrepair. Staff interviews revealed the fridge was reported to be in disrepair to management and a work order was submitted. LPA Ramirez did not observe food stored in this fridge. LPA Ramirez observed 2 additional refrigerators and a freezer that contained sufficient fresh and frozen foods. LPA Ramirez will issue Technical Violation based on this observation. Disaster Preparedness: The facility has the Emergency Disaster Plan (LIC610D/9 pages) in place. Last documented emergency drills were conducted on 11/10/2025. LPA Ramirez observed facility sketches with exits and emergency exits routes throughout various locations of the facility. LPA Ramirez observed emergency food supply located in kitchen pantry area. Residents with Special Needs : No large bodies of water were observed LPA Ramirez observed signs posted indicating “No smoking - Oxygen in Use” in various locations of the facility. LPA Ramirez observed several oxygen tanks in resident rooms secured in stands. Knives, sharps or other items that could pose a danger to residents with dementia, were observed to be inaccessible. Auditory devices were observed to be in working order. Health Related Services/Incidental Medical Services: The medications are centrally stored in the medication cart and in bubble packs and/or original containers. LPA Ramirez observed Centrally Stored Medication and Destruction Record. The facility provides incidental medical services. Staffing: Administrator Certificate for Celina Vasquez which expires 12/15/2025. Staff employed are over the age of 18 and are fingerprint cleared and associated to the facility. Personnel Records Training: Staff files are maintained at the facility. LPA Ramirez observed required annual training, CPR and First Aid for two (2) out of the two (2) personnel record reviewed. LPA Ramirez observed TB testing results, Health screening, fingerprint clearance and job application for two (2) out of the two (2) personnel record reviewed. Infection Control: Staff are using appropriate hand hygiene and wearing gloves while assisting clients. Staff are cleaning and disinfecting often for high touched surfaces. Facility has an Infection Control Plan in place. See 809-C Operational Requirements: Fire clearance is approved for twenty (20) non-ambulatory residents over the age of 59 years old. Approved for twenty (20) bedridden. This facility may retain no more than ten (10) hospice residents. There were seven (7) residents on hospice during time of inspection. Resident Records/Incident Reports: LPA reviewed resident records for three (3) residents in care. Resident records are maintained at the facility. Admission Agreement, Physician's Report (including T.B and Ambulatory Status), Consent for Medical Treatment, Preplacement Appraisal Information, Resident Pre-Appraisal, Care Plan/Appraisal/Needs and Services Plan, Resident Rights were observed. One (1) deficiency was issued during inspection. Three (3) technical violations were issued. Exit interview was conducted. A copy of this report, 809-D, LIC 9102 and appeals rights was provided.