Routine inspection·May 20, 2025

05/20/2025, Licensing Program Analyst (LPA) Loera conducted an unannounced Annual Required – 1 yr. inspection visit for this facility. Facility has an emergency disaster plan as required. Facility has an infection control plan as required. There are currently 4 residents in care. Facility approved/cleared for 4 non-ambulatory and hospice waiver for 1. LPA and Administrator toured the building and grounds. The facility was found to be at a comfortable temperature. LPA observed a 2 day supply of perishable and 7 day supply of non-perishable food. Refrigerated food was found to be stored in a safe manner being labeled and dated. Facility has a food menu posted. Emergency supplies are located in the garage. All rooms were furnished per regulation. Extra hygiene products and linens were available. Water temperature in sinks accessible to residents in care were measured and found to be within the range of 105 to 120 degrees F. Fire extinguishers were last inspected 05/2024. Facilities last fire/disaster drill was conducted 04/17/2025. Smoke/Carbon Monoxide detectors located throughout the facility were tested and operational. Toxins, sharps and other items that could pose threat if available to residents were located in the garage and in the kitchen and found to be secured. LPA conducted spot medication count and found all prescription medication to be properly recorded on the Centrally Stored Medication Record. continued on LIC809-C LPA conducted a review of 4 resident records. P&I monies were documented. All records had the required documentation. LPA conducted review of 4 staff records/training. Upon a review of staff records, LPA found all staff to have required training as well as current 1st Aid & CPR certification on file. No deficiencies cited during today's inspection. Updated copies of the following documents were requested for facility file and are to be submitted to CCL by 06/21/2025: LIC500- Personnel Report LIC308- Designation of Responsibility Updated Liability Insurance Exit interview conducted with Administrator and a copy of this report was provided .