Routine inspection·April 22, 2025

04/22/2025, 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 5 residents in care. Facility approved/cleared for 6 non-ambulatory, and hospice waiver for 2. LPA was greeted by staff. Administrator arrived shortly after. At approximately 12:40 PM, LPA and Administrator toured the building and grounds. The facility was found to be at a comfortable temperature with all exits free from obstruction. 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. LPA observed an activities calendar and as well as a food menu. All rooms were furnished per regulation. All rooms were in good repair. Extra hygiene products and linens were available. Water temperature in sinks accessible to residents in care were measured at 110.2 and 111.9 degrees F which is within the range of 105 to 120 degrees F. Fire extinguishers were last inspected 05/2024. Smoke/Carbon Monoxide detectors located throughout the facility were tested and operational. Facilities last fire/disaster drill was conducted 3/3/2025. Toxins, sharps and other items that could pose threat if available to residents were located in the garage and under the kitchen sink and found to be secured. Medications were found to be centrally stored. 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 3 resident records. All records had the required documentation. LPA conducted review of 3 staff records/training. Upon a review of staff records, LPA found all staff to have required annual and initial 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 05/23/2025: LIC500- Personnel Report LIC308- Designation of Responsibility LIC402- Surety Bond Liability Insurance Exit interview conducted with Administrator and a copy of this report was provided .