Routine inspection·March 21, 2025

Licensing Program Analyst (LPA) Jerome Haley conducted an unannounced visit for the purpose of conducting a required one-year annual inspection. LPA Haley was greeted and granted entry by staff who contacted Licensee/Administrator (AD) Maylene Gabat who was unable to attend the visit. AD Maylene has a current Administrators certificate that expires November 19, 2026. Matsonia Lane Homes is a one-story community with five bedrooms and two bathrooms. The current capacity is 3 and the census was 2 during the visit. During the inspection, LPA Haley observed all resident bedrooms. The bedrooms had all the requirements and were in compliance with regulation guidelines. In the hallway near the main bathroom, LPA Haley observed incontinent care supplies. A Carbon monoxide detector was observed in the hallway and tested operational. In a hallway closet right cross from the kitchen there is a closet with a nonperishable food supply. Resident bathrooms were observed. Hot water temperatures were measured in between 111.2 degrees Fahrenheit and 111.5 degrees Fahrenheit. No hazardous items were observed in the resident bathrooms. In the kitchen LPA observed a perishable food supply in compliance with regulation requirements. Knives and sharp objects are kept locked in a drawer near the sink. No hazardous cleaning chemicals are stored in the garage. The stove was being used to prepare lunch for the residents and two of the burners were in good working order. However, after staff finished cooking and the other two burners were checked, the top left burner was observed to be non-operational. A first aid kit with all the required elements was observed in a drawer in the dining room. The fire extinguisher was fully charged and mounted on the wall in the kitchen/dining room next to the refrigerator. Resident files are kept in a locked file cabinet in the dining room. In the same locked cabinet are emergency bags for each resident, an emergency water supply, and resident medications. Continued on LIC809C In the garage, LPA Haley observed a laundry area with a washer and dryer, a locked cabinet with all the hazardous cleaning chemicals, an office area, and filing cabinets with staff files and other facility files. There’s an additional refrigerator with an additional food supply and refrigerated medication for one of the residents. The backyard was clean and organized. No tripping hazards were observed. There is a swimming pool in the backyard surrounded by a self-latching gate that measured 5 feet off the ground at the entrance of the gate. Smoke detectors were observed in all resident rooms and the hallway, all of which tested operational. Emergency drills have not been conducted. 2 staff files, 2 resident files, and 3 resident medications were reviewed during the inspection. Deficiencies are being cited as a result of today’s visit. An exit interview conducted and a copy of this report, and appeal rights was provided to staff.