Routine inspection·October 16, 2025

Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced required 1-year visit with the primary focus on Infection Control measures and using the new CARE Inspection Tool. Upon arrival at the facility, LPA Bunker conducted a risk assessment. Based on the evaluation, the facility is clear of COVID-19 infection. LPA Bunker met Licensing Gwendolyn "Gwen" Craig and explained the purpose of today's Annual Inspection. LPA verified that the facility has an approved mitigation plan report and infection control plan. There are currently 3 Adult Residential Care Facility (ARF) consumers in placement. The facility's annual fees are up to date. The following 12 Domains will be observed and evaluated: Infection Control, Physical Plant & Environmental Safety, Operational Requirements, Staffing, Personnel Records-Training, Client Rights-Information, Client Records-Incident Reports, Food Service, Health-Related Services, Incidental Medical Services, Disaster Preparedness, and Emergency Intervention. "LPA Bunker will be using this tool and methods that have been developed to improve the efficiency and accuracy of the Department of Social Services' facility inspections." Licensee Ms. Craig and LPA Bunker toured the facility, a two-story commercial residential facility located in a mixed-use business and residential neighborhood. The facility includes four (4) bedrooms, two (2) full bathrooms, a receptionist area, a living/family room, a dining room, an office, a kitchen, a laundry room, and a storage room. It features a shaded balcony patio and an indoor/outdoor activity area located at the rear of the building. A community parking structure is situated on the left side of the property. Three (3) exits are located in the upstairs entryway: near the dining room, the living room, and the back exit door adjacent to the laundry room. The front and backyard landscapes were in good condition. See continued LIC809-C page 2 Continued LIC809-C page 2 During the tour, LPA Bunker observed sanitizer, a visitor log, and a thermometer at the facility entrance. Logs of daily COVID-19 screening and temperature checks of clients and staff were available and updated. PPE supplies are readily available to staff, and an additional supply of PPE was observed. Sufficient liquid soap, paper goods, cleaning, and disinfecting supplies were observed. Documents are posted in the facility hallway on the bulletin board. The following Title 22 regulated areas were audited and found to be in compliance: The facility telephones are working. Bedrooms: All bedrooms meet the required standards for furniture, safety, privacy, and comfort. The facility has an adequate linen supply. Bathrooms: The bathrooms are clean and operational, and provide necessary personal accommodations with non-skid surface mats ensuring safety and privacy. Kitchen and Food Service: The kitchen is adequately equipped for food preparation and service. A review of the food service revealed an ample supply of perishable and nonperishable food, stored appropriately. Medication Storage and Management: Medications are centrally stored in a locked cabinet in the hallway with up-to-date records, ensuring proper storage and documentation. Common Areas: The Living room, dining room, and common areas are well-maintained, free of potential hazards, and meet the cleanliness standards necessary for the safety and well-being of residents. Safety Equipment and Measures: The facility is equipped with a fully stocked first aid kit with manual, functional smoke and carbon monoxide detectors, and properly charged fire extinguishers. The hot water temperature is measured at 106.2 degrees and is maintained within the standard range of 105-120 degrees Fahrenheit. Emergency Preparedness: All exit doors are in compliance, the client's bedroom windows are equipped with sliding window locks without thumbscrews, and the facility conducted a fire drill on May 16, 2025. Environmental Safety: The yard is free from debris and hazards, trash cans are covered, and no firearms or bodies of water are present on the premises. Hazardous items are kept inaccessible to clients. Staff Training: Staff members have received training on reporting dependent adult and elder abuse. Administrative Compliance: The Administrator has successfully completed the required training. The Administrator Certificate is current and expires on November 09, 2026 LPA Bunker provided Licensee Gwendolyn "Gwen" Craig with a copy of the facility evaluation reports. There were no deficiencies cited. An exit interview was conducted.