Routine inspection·October 3, 2025

On 10/03/25, Licensing Program Analyst (LPA) Mario Leon conducted an unannounced required – annual inspection and met with staff one, Matt Palmer - Administrator (S1) and staff two, Jerick Calpito - House Manager (S2) and the purpose of the visit was explained. The facility is licensed for (6) non-ambulatory of which (1) maybe bedridden for ages 60 and above. It is also licensed for (6) hospice residents. Currently, there are five (5) residents of which (2) residents receiving hospice care and (1) bedridden resident. Facility is a one-story family home with (6) bedrooms, (2) full bathrooms, (½) half bathroom, living room, dining room, office area, closet/storage space (located in the hallway), kitchen, patio, and backyard. A one (1) car attached garage is located on the front of the property. Front yard landscape is in good condition at time of visit. There is one wheelchair ramp on the left front side of the house that connects to the back-left side of the backyard. There is one located on the center patio deck across from the living room. One located center back against the home, and one located to the right-hand side of the kitchen and dining room. Washer/Dryer appliances are located in the garage. The facility is clean, sanitary, and in good repair. LPA toured the inside and outside the facility during this inspection. Outside grounds were toured and no bodies of water were observed. All exits and walkways around the home were clear of obstruction. 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 and a non-skid mat was in place, and hot water temperature properly measured at One-hundred and eight degrees Fahrenheit (108.4°F). Resident bath towels, toiletries and personal hygiene supplies were adequately stocked. Report continues, please see LIC809C LPA toured the kitchen area and observed a two-day supply of perishable and a seven-day supply of non-perishable food, all stored properly. Knives and toxins were kept in locked kitchen cabinet. First Aid kit was available. One fire extinguisher, last serviced on August 22nd, 2025 (08/22/25) was observed across from the kitchen area. House Manager tested the carbon monoxide detector and smoke detectors in the house. Both devices were functional and interconnected. Five resident records were reviewed and 5 out of 5 resident records had medical assessments, appraisals and pre-appraisals. There have been zero (0) deficiencies cited during today's visit. An exit interview was held with Matt Palmer (S1) and a copy of this report was left with the Administrator, Matthew Palmer.