Routine inspection (multi-day)·August 29, 2025

On 08/21/25, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced required – annual inspection and met with Administrator JM Demafelix. The Area Manager Irene Formentera arrived later. On 08/29/25, LPA conducted an unannounced annual continuation. The facility is licensed to serve six (6) residents aged 60 and over. Six (6) bedridden residents are approved in Rooms A, B, C, D, E, and F. There is currently one bedridden resident. The facility has an approved hospice waiver for six (6). Annual Fees are current. The facility is a single-story house located in a residential neighborhood and consists of six (6) bedrooms, three (3) bathrooms, kitchen, activity room, living room, dining room, and an attached garage. The facility is clean, sanitary, and in good repair. The House Manager 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. Common areas were clean, clear of hazards, and doorways were free of obstruction. 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, a non-skid mat was in place, and hot water temperature properly measured at 109.6F. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. 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 locked. First Aid kit was available. One fire extinguisher, last serviced August 22, 2025 was observed in the kitchen area and in the garage. The Administrator tested the carbon monoxide detector and smoke detectors in the house. Both devices were functional. Six staff records were reviewed and six out of six staff records had the required criminal record clearances or criminal record exemptions. Three resident records were reviewed and three out of three resident records had medical assessments and pre-appraisal or reappraisals. 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 Irene Formentera.