Routine inspection·October 30, 2025

On October 30, 2025, Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced required visit using the CARE Inspection Tool. LPA was greeted by staff and granted entry after stating the purpose of the visit. Administrator Maria Manimbo was available to assist with the facility inspection. The facility is licensed for capacity six residents, four (4) non-ambulatory residents with approved hospice waiver for four (4) residents. Currently, there are one (1) Hospice residents present during today’s visit. This is a single story with a detached garage facility. The facility has five bedrooms( three shared resident rooms and two staff rooms) and three bathrooms. At around 7:45AM, LPA conducted a tour of the physical plant accompanied by Administrator Maria Manimbo, and the following was observed: There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the client's personal belongings was observed. Bed linens and bath towels were available during the visit. Bathrooms were operational with water temperature measured at 118.5 degrees F. A comfortable temperature of 74 degrees was maintained in the facility. LPA observed the facility to be furnished at the time of the visit. Storage areas for hygiene products, cleaning supplies and sharps objects were stored and not accessible to residents. The kitchen was inspected, and sufficient two day perishable and seven day non-perishable food was maintained adequately. CONTINUED ON 809C Facility has supply of emergency food and water. Facility has two fire extinguishers which were mounted and fully charged. A review of the Medication Records Administration (MAR) was conducted, and LPA observed the records are in compliance. During the visit, LPA observed screening protocols for visitors, staff, and residents. LPA observed the facility has supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. LPA observed First Aid Kit was maintained. A working landline phone with phone number 657-230-7124 was operational. The last fire drill was conducted on 9/12/2025. The facility had operational smoke and carbon monoxide in bedrooms and common areas. The facility has current liability insurance on file effective 8/4/2025 – 8/4/2026. A review of two residents (R1-R2) service files and two staff (S1-S2) personnel files revealed to be complete. LPA reviewed Administrator Certification active list and the current administrator's certification is on file for Maria Nelly Manimbo # 7000737740 - Expiration 4/26/2027 No deficiencies during this inspection visit. An exit interview was conducted with Administrator Maria Manimbo, and a copy of the report was provided.