Routine inspection·September 18, 2025

Licensing Program Analyst (LPA) Galarza conducted an unannounced annual inspection visit. The purpose of the visit was explained to caregiver Salvador Huerta. Administrator Thomas Thrice arrived shortly after. The facility serves elderly residents ages 60 and older. The following were observed/inspected: Infection Control: The Infection Control Plan was reviewed and includes environmental cleaning and disinfection activities. Facility has sufficient Personal Protective Equipment. Operational Requirements: A Dementia and hospice waiver for 4 residents has been approved. A fire clearance for 6 non-ambulatory and 1 bedridden resident is in place. Facility does not handle resident P & I monies. Liability Insurance in the amount of at least ($1,000,000) per occurrence and ($3,000,000) in total annual aggregate is current with an expiration date of 10/21/2025. Physical Plant/Environment Safety: The facility is a single story home located in a residential neighborhood. The facility is a single story home located in a residential neighborhood consisting of 4 resident bedrooms (2 shared and 2 private), 2 bathrooms, living room, dining room, kitchen, den, live-in staff room, outdoor covered patio area, carport, and detached laundry room. Smoke and carbon monoxide detectors were tested and are operational. The facility has one (1) fire extinguisher. Water temperature readings measured within the required 105 - 120 degrees Fahrenheit. The facility has a 1st Aid Kit and Manual. Cleaning supplies, knives, and toxic substances are inaccessible to residents. Exit doors are free of any obstruction and there are no pools or large bodies of water. The last Emergency Disaster drill was conducted on 6/28/2025. Oxygen was in use in room #1, but no sign was posted. Staffing: A total 7 staff members provide care and supervision to the clients. Personnel Records/Staff Training: Administrator certificate expires 12/1/2026. Staff have criminal background clearance and training. Four (4) staff files were reviewed. Proof of staff training, health clearance, and 1st Aid/CPR training is current. Resident Records/Incident Reports: A total of six (6) resident files were reviewed. They contained admission agreements, Physician's Reports, Appraisals, TB clearance, Physician's Orders, medical consent. Medication Administration records are in place. RCFE and Ombudsman complaint posters are posted. Planned Activities: Sufficient space to accommodate both indoor and outdoor activities was observed. The facility does not have a Resident Council. Food Service: Sufficient food supply is stored in the kitchen and pantry areas consisting of: 2-day perishables, 7-day non-perishables, and emergency food supplies. Residents have modified diets. Incident Medical and Dental: Centrally stored resident medications were reviewed. 30-day supply of medications was observed. Medical and dental transportation is provided by family. Disaster Preparedness: Emergency and Disaster Plan LIC 610E was reviewed. Facility has a First Aid Kit and Manual. Residents with Special Health Needs: Two (2) resident receives hospice services and two (2) resident receives home health services. No residents have prohibited health conditions. Bed rails, hoyer lifts, and special equipment are used by residents for mobility assistance. Pursuant to Title 22, a citation was issued. An exit interview was conducted with Administrator Thomas Thrice. A copy of the report and appeal rights was provided.