Routine inspection·September 19, 2025

On September 19, 2025, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to conduct the required annual inspection. LPA was greeted and granted entry into the facility by care giving staff after explaining the purpose for the visit. Licensee (LI) Myrna Adriano was notified via telephone and later arrived to assist with the inspection. LPA observed that Myrna Adriano has a valid Administrator certificate which expires on March 3, 2027. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for five non-ambulatory residents, one bedridden resident, and has a hospice waiver for four. The facility is a single story home with four resident bedrooms, three bathrooms, a living room, a dining room, a kitchen, and an attached two car garage. LPA, accompanied by the LI, conducted a tour of the interior portions of the facility. On today's visit, LPA observed three resident in care and two staff present. LPA observed residents watching TV in their respective bedrooms. LPA observed the See Something, Say Something poster, (PUB 475) mounted on the wall by the entryway of the facility. LPA inspected all four resident bedrooms and observed them to be free of hazards. LPA observed resident bedrooms to have the required furnishings of a bed, a chair, a chest of drawers, and a lamp. LPA observed resident beds to have clean linens and blankets. LPA observed additional linens to be stored in a hallway closet. LPA inspected the two resident bathrooms and observed them to be clean. Bathrooms were equipped with grab bars and non-skid floor mats. Faucets and toilets were operational. Hot water temperature measured between 124.5 and 125.9 degrees Fahrenheit. LPA observed the kitchen has a two day perishable and a seven day non-perishable food supply on hand. LPA observed kitchen appliances to be clean and operational. LPA observed kitchen knives and sharps to be stored in a locked kitchen cabinet. CONTINUED ON LIC809-C LPA observed chemicals and toxins to be stored in a locked cabinet near the kitchen. LPA observed a fire extinguisher to be mounted on the wall in the kitchen and it was observed to be charged and serviced as of August 25, 2025. LPA tested the individual smoke detectors/carbon monoxide detectors which tested operational. LPA observed the facility conducted their last emergency disaster drill on April 8, 2025. LPA observed the centrally stored medication to be kept in a locked closet in the resident hallway. LPA observed the facility has a First Aid Kit stored in the locked closet and it had all the required components. LPA observed oxygen in use signs to be posted in the appropriate areas. LPA observed the facility has a three day emergency food and water supply stored in the dining room. LPA observed the door leading to the attached two car garage to be kept locked and inaccessible to residents in care. LPA observed the two car garage to be used for storage. LPA observed additional incontinence supplies stored in the garage. LPA, accompanied by the LI, conducted a tour of the exterior portion of the facility. The exterior portion was observed to be free of hazards and obstructions. LPA observed a shaded outdoor seating area with furniture for resident use. LPA observed a pool located in the backyard. The pool was observed to be kept adequately fenced and locked for resident safety. LPA observed the perimeter gates of the facility to be self latching and can be opened in an evacuation. LPA reviewed all three resident files. All the required documentation were present and current in the resident file reviewed. LPA reviewed the residents' medication and medication records. LPA reviewed two staff files. All staff are background cleared and associated to the facility. Based on the observations made during today's visit, a deficiency is being cited on the attached LIC809-D. An exit interview was conducted with Licensee Myrna Adriano. A copy of the report and appeal rights were provided.