Routine inspection (multi-day)·October 15, 2025

On 10/15/25, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced required – annual continuation inspection and met with Administrators Simla Mehta and Jeniffer Bobadillia and Staff Elenita. The facility is licensed to serve six (6) non-ambulatory residents age 60 and above. The facility has an approved hospice waiver for six (6) residents and two (2) residents are currently receiving hospice services. Annual Fees are current. The facility is a two-story home. The first floor is where the residents reside and consists of the following: six (6) resident bedrooms, three (3) full bathroom, one (1) staff room and one (1) staff restroom, den, living room, kitchen, dining room, laundry room, attached garage and an outdoor shaded patio and gazebo area. The facility is clean, sanitary, and in good repair. On 10/10/25, Staff accompanied LPA inside and outside the facility during this inspection. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. Continue to LIC809-C. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. There are no security bars or weapons on the premises. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, hot water temperature properly measured between 106 degree Fahrenheit. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards. Doorways were free of obstructions. LPA toured the kitchen area and observed a two-day supply of perishable and a seven-day supply of non-perishable food. Knives and toxins were kept in locked storage cabinet. First Aid kit was available. Two fire extinguishers, last serviced 06/18/25 was observed in the kitchen and in the hallway. Hedrick Fire Protection inspected the fire alarm in 06/25. The last fire drill was conducted on 09/09/25. On 10/15/25, five (5) staff records were reviewed, five (5) out of five (5) staff records had current first aid certificates and required criminal record clearances or criminal record exemptions. On 10/10/25, five (5) resident records were reviewed. On 10/15/25, two residents’ medication was reviewed. No deficiencies are being cited. An exit interview was conducted, technical assistance provided, and a copy of this report was discussed and left with Administrator Jeniffer Bobadillia.