Routine inspection·August 29, 2023

Licensing Program Analyst (LPA) Mary Flores conducted an unannounced annual visit at the facility using the CARE tool. LPA met with Elvira Rocche Caregiver and explained the reason for the visit. Administrator arrived 10 minutes later. The facility is licensed to serve 6 non-ambulatory residents age 60 and over, with a hospice waiver approved for 4. Facility is a single home located in a residential area and consist of: 4 bedrooms, 3 bathrooms, living room, dining room, kitchen, and detached garage. LPA Flores toured the facility with Elvira Rocche and Amanda Palomino and observed the following: Facility is clean and in good repair inside and outside. Living room has sufficient seating space and activity area was observed. Kitchen was observed clean, knives were stored in a cabinet with a magnet lock. Refrigerator/pantry was observed with sufficient food supplies for at least 2 days of perishables and 7 days of non-perishables. Cleaning supplies were observed locked in the laundry. Dining/family room was observed with sufficient seating area. Each residents' room was observed with the required furniture, bedding and sufficient lighting. A locked closet was observed with medications and additional linens. Bathrooms (3) were observed in working condition and water temperature was tested between 114.0 - 115.5 degrees F., which is within the required 105-120 degrees F. Backyard has a shaded seating area and no pools or bodies of water were observed. Smoke/Carbon Monoxide detectors were tested and are in working condition. LPA Flores reviewed medication and files for 5 residents and 5 staff files. Administrator certificate was observed for Boris Palomino #6031265740 exp. date: 6/15/24. Disaster plan was reviewed, last evacuation drill was conducted on 6/1/23. LPA interviewed 2 staff and 2 residents. No deficiencies were noted during this visit. Exit interview was conducted with administrator and a copy of this report was provided.