Routine inspection·December 8, 2025

At approximately 10:30 AM, Licensing Program Analyst (LPA) Julie Florio arrived unannounced to conduct a required 1-year annual inspection and met with Angelina Simi, Administrator. Facility is a Residential Care Facility for the Elderly (RCFE) with six (6) residents in care; five (5) of whom were present during today's inspection. Facility is approved for six (6) non-ambulatory residents, has a Dementia Care Plan, a Hospice waiver for three (3), and is approved for one (1) bedridden resident. At approximately 11:30 AM, LPA initiated a tour of the facility with Administrator and observed the following: Facility is a two story home, was a comfortable temperature, and passageways were free from obstructions. All resident rooms are situated on the main floor of facility. The upper and lower level stairs were observed secured by gates and are used for office, storage, and staff lounge space. Water temperatures in residents' bathrooms measured within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens, and hygiene, incontinent care, and paper products available for residents. Residents' bedrooms were inspected and observed to have all the appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. Facility has at least two days of perishable food and one week of non-perishable foods, as well as an emergency water supply. Medications were centrally stored and locked. There is a shaded seating area in the front and backyards with outdoor space for activities. LPA observed a locked structure on the property which is vacant and has paint and renovation materials inside. LPA observed an empty and sealed hot tub in the rear yard of facility as well as a gated and locked pool. Facility's internet access device broke and facility is in the process of replacing it in order to have an internet access device available for resident use as required per regulation. Facility has internet service available to residents in care and the telephone was tested an operational during inspection. Continued on LIC809-C... Continued from LIC809C... Facility's fire extinguishers were observed charged and were last serviced 09/2025. Smoke and Carbon Monoxide detectors were tested and operational during inspection. The local fire department conducts annual fire inspections of the facility with the the last one conducted last week. Administrator agrees to submit a copy of the final report to the Department upon receipt and within 30 days of today's visit. Facility conducts quarterly disaster drills, and the most recent drill was conducted 10/2025. LPA observed the facility's infection control plan, first aid kit, PPE, and emergency supplies for emergency preparedness. LPA reviewed facility's emergency disaster plan last updated 09/2025. At approximately 1:30 PM, LPA conducted file review. Three (3) staff files and three (3) resident files were reviewed. All staff files reviewed contained proof of the required training as well as as current First Aid and CPR certifications. All resident files reviewed contained the required documentation. Administrator states that most of the residents' family members coordinate residents' medical and dental appointments and transportation to and from visits. However, Administrator is available to assist with this as needed. Medications and medication records were inspected and the logs were observed maintained in compliance with regulation. Facility does not handle P&I. Updated copies of the following documents are to be submitted to CCL within 30 days of this visit : LIC500 - Personnel Report (updated) LIC610E - Emergency Disaster Plan (Updated) Annual Fire Inspection Report No deficiencies cited during today's inspection. Exit interview conducted with Administrator whose signature on form confirms receipt of documents.