Routine inspection·September 20, 2025

On 09/20/25 at 9:15AM, Licensing Program Analyst (LPA) Gina Saucedo, arrived to conduct an unannounced, annual inspection at the facility. Upon arrival, LPA Saucedo met with Caregiver, Norman Meadows and disclosed the purpose of the visit. The Administrator, Renee Faulkner arrived about thirty (30) minutes later. LPA asked for the census, resident, and staff files. A physical tour was conducted at 10:10am and observed the following: The Kitchen area was toured, and LPA observed there to be sufficient seven (7) day supply of non-perishable foods and perishable food for all residents. The kitchen area was clean at the time of the tour. The fire extinguisher is located against the wall on your right-hand side of the kitchen. It is fully charged dated 12/23/2024. There is extra, food emergency kits in the kitchen and in the kitchen pantry. The sharps are locked and inaccessible to the residents in one (1) of the right side cabinets. The medication is also locked and inaccessible to the residents in one (1) right hand side cabinets. Outside/Backyard: There is a ramp at the entrance of the facility. The outside/backyard has furniture for residents with proper seating. The facility has a cameras in common areas. The facility has no pool or bodies of water. There is a garage that can be accessed from the living room area. The garage has extra storage. LIC 809C-continued Bedrooms and Bathrooms: There are four (4) bedrooms, one (1) 1/2 bedrooms. There are four (4) bedrooms that are single, occupied with no bathroom. Two (2) bedrooms are currently unoccupied. All bedrooms and bathrooms were toured and were properly furnished and have appropriate bedding, linens, toiletry and lightning. There is one (1) and half bathrooms for resident and staff use. The bathrooms have proper toiletry and grab bars. The bathroom temperatures of the water are within regulations reading at 108.3 degrees Fahrenheit. There is no staff bedroom. There is also extra linen kept in the hallways in between the bedrooms and bathroom. The dining area/living room area has enough seating for the residents and the staff. There is a large television against the wall and there is also internet access and telephone access. There is one (1) washer and dryer. There are chemicals/toxins that are kept in this area that are locked and inaccessible to the residents. The carbon monoxide and smoke detectors are located throughout the facility and are operable and interconnected. The house temperature is set at 75 degrees. Administrative: At the entrance of the facility on your left-hand side there is COVID signs, YES signs, Emergency Disaster Plan, Rights of Resident Council, Personal Rights, Theft and Loss, Ombudsman sign The insurance plan is updated and is dated 12/2025. The last emergency disaster drill was July of 2025. There is one (1) transportation vehicle that is mandatory to have which is available and functioning. Staff and Resident Files were reviewed: Resident files were missing physician's report/tuberculosis, resident appraisal, pre-appraisal and functional capabilities. Both residents observed were ambulatory. An exit interview was conducted, citation(s) were issued, appeal rights was provided and a copy of this report was given to the administrator.