Routine inspection·September 11, 2025

Licensing Program Analyst(LPA) Nune Margaryan conducted an unannounced annual visit using the Care Tool. LPA met with Sherry Fischer, Executive Director / Administrator, who assisted with visit. LPA explained the reason for the visit. The facility is licensed to RCFE/Dementia for age range 60 and over. Approved for 150 non-ambulatory, of which 15 may be bedridden, approved in rooms in memory care unit. Hospice Waiver approved for 15 residents. The facility is a 5 story building. There are a total of 111 apartments, 13 of those in memory care unit and 2 of those 13 apartments will be shared. On the first floor (AL Unit), it included Receptionist/Front Desk, Staff Offices, Theater room/Activity Room, Resident Mailbox area, Salon/Spa Room, Maintenance Office, Wellness Center, Dining area, Facility Kitchen, Public bathrooms for Male and Female, Staff Lounge and Private Dining Room. Memory Care Unit (Garden House) is a secured building. It includes 13 residents rooms, living room, laundry room, public bathroom, medication room and office. A random sample of apartments were inspected on each floor/unit. Each resident apartment have the required furniture and sufficient lighting and closet space. The bathrooms are clean, sanitary and in a good working condition. All bathrooms have the required grab bar and non-skid mat. Water temperature was measured in various different resident apartments throughout the facility and measured between 113.7F - 117.4F which falls within Title 22 Regulations. A locked storage area for centrally stored medications were observed in both medication rooms (AL Unit and Memory Care Unit). First aid kits were observed throughout the facility which included all required supplies. The walls, ceilings, floors, windows, and areas around the facility were clean and in good repair. Several fire extinguishers were observed throughout the facility. LPA also inspected the carbon monoxide detectors in the facility, and they are working properly. Continue 809C Facility kitchen was inspected. All appliances are clean and were operating at the time of the visit. Sharps are locked in the kitchen and are inaccessible to residents. Food supply adequate stored in the kitchen, storage room and consists of the following: 2 days perishable and 7 days non-perishable. Cleaning supplies and toxins were observed locked and inaccessible to residents. Doors, exits, hallways, and passageways were clear and free of obstruction. There are no pools or bodies of water in or around the facility. The outdoor patio areas were observed to have well shaded areas and were furnished for outdoor use. The last fire drill was conducted on 08/22/25. LPA reviewed 10 resident records to confirm emergency contact is updated, physician's reports are on file, and admission agreements are complete. 5 staff records were reviewed to confirm health screenings, training, and fingerprint clearances. LPA reviewed residents medications. Medications are documented properly and given as prescribed. No deficiencies were observed during today's visit. Exit interview conducted and a copy of the report was provided to Administrator.