Routine inspection·February 20, 2025

Licensing Program Analyst (LPA) Cynthia Chan conducted the required annual inspection. LPA met with Staff, Taren Mente, and explained the purpose of the visit. The fire clearance has been approved for a capacity of 6 residents, which 5 may be non-ambulatory and 1 bedridden. Bedroom #6 is approved for bedridden. The hospice waiver is approved for 4 residents. LPA inspected the facility using the Compliance and Regulatory Enforcement (CARE) tools. Infection Control: Facility is continuing to follow their Infection Control plan. Staff are wearing gloves to assist residents. Operational Requirements: The facility has a dementia care plan to accept or retain residents with dementia. There are currently 4 residents residing at the facility. Structure/Physical Plant: The facility is a single story home with 6 private resident bedrooms, 1 staff room, 4 bathrooms (2 communal bathroom, 1 in bedroom #4, and 1 jack and jill bathroom), living room, dining room, kitchen, and attached garage. The facility has a swimming pool in the backyard and is surrounded by a locked gate. Bathrooms have non-skid mats in the shower area and grab bars. Knives, cleaning solutions, and disinfectants are locked. The hot water temperature was measured between the required range of 105-120 degrees F. The backyard has a table and chairs for residents to use. The facility has auditory devices at the exit doors and the resident room's sliding doors. Food Service : Sufficient food supplies of 2 day perishable and at least a week of non-perishable are observed. The kitchen is kept clean and sanitary. The refrigerator is maintained at 40 degrees F or below and the freezer at 0 degrees F or below. Planned Activities : The facility has sufficient space to accommodate indoor and outdoor activities. No deficiencies were observed today. LPA will return another day to complete the remainder of the domains. A copy of this report was given to Staff Taren.