Routine inspection·July 15, 2025

On July 15, 2025, at 2:15 PM, Licensing Program Analyst (LPA) Edward Kim conducted an unannounced required 1-Year annual visit using the CARE Inspection Tool. Upon arrival at the facility, LPA Kim met with Licensee (LI) Paul Chierichetti and explained the purpose of the visit. The facility is licensed to operate for six (6) non-ambulatory and have a hospice waiver for four (4) residents. The facility is a single-story building located in a residential neighborhood. It consists of the following: six (6) resident bedrooms, one (1) staff bedroom, seven (7) bathrooms, living area, family area, dining area, kitchen, attached 2-car garage, and two (2) outside covered patio area. LPA Kim toured indoor and outdoor of the physical plant with LI Chierichetti. There are no obstructions or bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in good condition, adequate lighting was provided, storage for each resident’s personal belongings was observed. Bed linens, comforters, and bath towels were adequately stocked at the time of visit. All bedrooms were inspected: Resident Room 1, Resident Room 2, Resident Room 3, Resident Room 4, Resident Room 5, Resident Room 6, and Staff Room 1. Bathrooms were found to be within Title 22 regulations and were clean and operational. The water temperature measured between 107.4 degrees F and 119.3 degrees F. A comfortable temperature of 75 degrees F was maintained in the facility. LPA Kim observed the facility to be sanitary and appropriately furnished at the time of visit. Storage areas for personal hygiene, cleaning supplies, toxins, and sharps objects were stored and not accessible to residents. Evaluation Report Continues on LIC 809-C The kitchen was inspected and there is a two-day supply of perishable and seven-day supply of non-perishable food available and maintained properly. Emergency food, water, and supplies are stored in the garage. The facility has one (1) fire extinguisher that is charged, mounted in the kitchen and was last inspected on July 14, 2025. All smoke/carbon monoxide detectors were operable. During the visit, LPA Kim observed the facility's infection control practices, plan of operation, and screening protocols for visitors, staff, and residents. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). The facility conducts Fire/Safety Drill monthly and was last conducted on July 11, 2025. A working telephone (714-646-9023) and tablet with video conferencing technology dedicated to residents both remain available. First Aid Kit contained all the necessary elements. Certificate of Liability Insurance is effective July 24, 2024, and expires on July 25, 2025 LPA conducted an audit of resident files (R1-R6), staff files (S1-S3) and medication and medication administration review that were all in order and complete. LPA Kim conducted 1 resident interview and 1 staff interview. No deficiencies were cited during the inspection visit. An exit interview was conducted, and a copy of this report was provided to Licensee Paul Chierichetti.