Routine inspection·September 18, 2025

On 09/18/25, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced Annual Visit using the CARE Inspection Tool. LPA met with Staff, Ricardo Huerbana, and the purpose of today’s visit was explained. LPA was granted entry into the facility. The facility is licensed to serve six (6) residents aged 60 and over. The facility is approved for six (6) non-ambulatory residents, of which 1 may be bedridden and a hospice waiver for four (4) residents. There are currently four (4) residents residing in the facility. Physical Plant/Structure The facility is a single-story structure in a residential neighborhood. It consists of three (3) bedrooms, two (2) bathrooms, living room, dining room, sitting area, kitchen, storage room, front yard, back yard with a shaded patio, and detached garage. All walkways around the facility were observed clean, clear, and free of debris, obstructions, and hazards. LPA did not observe any bodies of water on the premises. Bedrooms LPA inspected the three (3) resident bedrooms and observed them to be clean and in good repair. All rooms were observed with the required furniture including beds, dressers, nightstands with lamps, and ample storage space for residents’ personal belongings. LPA observed the beds had the required linens including a mattress cover, fitted sheets, blanket, comforter, and pillows. LPA observed an ample supply of linens, blankets, and comforters in good repair stored in a closet in the hallway. All bedrooms were observed with ample lighting. Bathrooms LPA inspected all bathrooms and observed them to be within Title 22 regulations and were clean and operational. All safety handrails were secured. LPA observed showers have non-skid mats and a shower chair. LPA observed an ample supply of hygiene products, incontinent products, and towels. The water temperature in the bathrooms measured 105.8- degrees and 105.5- degress Fahrenheit. Kitchen LPA inspected the facility kitchen and found it to be clean and sanitary. LPA observed all appliances to be operational and in good repair. LPA observed a 3- day supply of perishable foods and a 7-day supply of non-perishable foods, properly packaged, stored, and labeled. LPA observed all knives and sharps secured in a locked cabinet under the kitchen sink. LPA observed all cleaning and laundry supplies secured in a locked cabinet in the kitchen. LPA observed an ample supply of cookware, dishware, and cutlery in good repair. The water temperature in the kitchen measured 106.6- degree Fahrenheit. Common Rooms During the time of visit, LPA observed the facility to be appropriately furnished. The living room has recliners and a couch to accommodate all residents. The sitting area has a couch and lounger. LPA observed games, activities, puzzles, and reading material available for residents. The dining room has a large table with chairs to accommodate all residents. LPA observed a screened fireplace inaccessible to residents. The facility was maintained at a comfortable temperature. LPA observed all walkways and hallways in the home to be clean, clear, and free of obstructions and hazards. LPA observed all rooms and walkways have ample lighting. Files LPA reviewed the files for four (4) residents and found they contained the required documents. LPA reviewed the administrator and two (2) staff files and found they contain the required documents, certification, and training. The administrator’s Administrator Certificate, number 7005359740, is valid till 04/03/26. LPA observed all required posting posted throughout the facility. LPA received and reviewed a copy of the facility’s Liability insurance through Acord that is valid till 12/18/2025. LPA observed the facility’s Licensing Fees are current. Medications LPA observed all Centrally Stored Medication secured in a locked cabinet in the kitchen and are inaccessible to residents. Medications were observed in their original packaging. LPA reviewed the medications for four (4) residents and the Medication Administration Record (MAR) and found the medications to be consistent with properly documented records. Safety LPA observed the smoke and carbon monoxide detectors to be fully operational. LPA observed two fully charged fire extinguishers, one in the kitchen, and the other in the living room near the entrance, purchased on 04/21/25. The last emergency drill was conducted on 06/21/25. All exits are marked with an EXIT sign. LPA inspected the First Aid Kit and observed it has the required items and a current manual. The facility has a working landline telephone. LPA observed all emergency phone numbers and Emergency Disaster Plan posted in the kitchen. There are no firearms or ammunition stored on the premises. Infection Control LPA reviewed and observed the facility’s infection control plan posted on the wall. LPA observed sanitizing stations throughout the facility. LPA observed masks and gloves available. LPA observed staff wearing gloves while working with residents. LPA observed a 30-day supply of Personal Protective Equipment (PPE). LPA observed Infection Control signs posted throughout the facility. LPA did not observe or cite any deficiencies. An exit interview was conducted with Staff, Ricardo Huerbana, and a copy of this report was provided.