Non-compliance follow-up·September 15, 2025

At approximately 10:30AM, Licensing Program Analyst (LPA) Julie Florio arrived at this facility unannounced to conduct a Case Management Legal/Non-Compliance visit and was greeted by staff. Administrator Mary Grace Defeo was contacted via telephone and arrived at approximately 11:45AM. This facility was placed into Non-Compliance for the following reasons: Lack of Liability Insurance in the proper amounts Lack of proper funds to properly maintain facility LPA toured the facility to ensure residents were safe and secure and to ensure there was proper amounts of food stores, power, water and heat. The temperature inside the facility was comfortable and facility had power, water and heat. Food stores were sufficient to sustain residents in care for seven (7) days as required per regulation. LPA requested copies of all facility financial documents due today 09/15/2025 for 2nd Quarter 2025: April, May, June 2025 monitoring period to include: 1. Profit & Loss statements for the months identified above or in the report 2. Rent, payroll, income & expense third party documents such as utility statements (gas, electric, etc) supporting the amounts entered on the LIC401 3. Balance sheet for June 2025, and supporting third party documents, such as liabilities (loans, credit cards) supporting the amounts entered on LIC403 4. All Bank statements used for the operation of the facility for the months identified, cash reserve documents for the facility's emergency needs 5. Current General Liability Insurance and Workers Compensation Insurance. Continued on LIC809C... Continued from LIC809... 6. Any financial records deemed relevant to support the licensee has an adequate financial plan, as required by law, such as Form 941, the Employer's Quarterly Federal Tax Return, & Quarterly Contribution Return and Report of Wage - DE 9. Additionally, LPA requested a copy of any permits regarding the renovation of the facility dining area into a bedroom/staff room/office. Administrator agreed to follow up and submit. LPA will return to regional office to conduct further file review and consult with licensing program manager (LPM). No citations issued during today's visit. Exit interview conducted with Administrator whose signature on form confirms receipt of documents.