Routine inspection·April 8, 2025

Licensing Program Analyst (LPA) William Vanegas made an unannounced inspection for the purposes of conducting an annual inspection. Upon arrival LPA Vanegas was greeted and granted entry to the facility by Care Giver (CG) Myra Miciano and explained the purpose of the inspection. LPA Vanegas set up equipment and began a tour of the facility and observed the following. This is a two storied home with an attached two car garage. There is a total of eight bedrooms five of which are resident rooms, and three of which are staff rooms. There are four bathrooms two of which are shared, one of which is a private bathroom, and one of which is for staff use. LPA Vanegas observed kitchen area to be clean and sanitary. LPA Vanegas observed a dishwasher, refrigerator, microwave, electric stove, washer, and dryer to be in good repair and working condition. LPA Vanegas observed resident bathrooms to be clean and free of any mildew and debris. LPA Vanegas observed restrooms to have all required furnishings such as grab bars, slip resistant matts, and shower chairs. LPA Vanegas observed water faucets and toilets to be functional. Water to be between 115.2 and 117.2 degrees. LPA Vanegas observed resident rooms to have all required furnishings such as a bed, chest drawers, enough closet space for personal belongings, and clean linens in good repair meaning no strains or tears. Rooms are large enough to walk about freely, and no obstructions are blocking the entry ways. LPA Vanegas toured the outside of the facility and observed the following. There is a large backyard with an outdoor shaded sitting area. No obstructions were observed along the exit route. Side door is self latching and unlocked. CONTINUED ON LIC809C LPA Vanegas reviewed medications with Care Giver (CG) Myra Miciano. Per LPA Vanegas review medications are being administered to residents in care per physicians orders. LPA Vanegas observed medications being documented correctly and in the correct order. LPA Vanegas observed all fire extinguishers to be updated and fully charged, LPA Vanegas observed all smoke and carbon monoxide detectors to be in good repair and operational. LPA Vanegas observed first aid kit to have all required items such as adhesive tape, bandages, scissors, tweezers, and a thermometer. LPA Vanegas reviewed five resident files, and two staff files. All files (staff and resident) had all required documents. All staff annual training was up to date and documented. Based on observations made during today's inspection no deficiencies will be cited per tittle 22 chapter 8 division 6. An exit interview was conducted with CG Myra Miciano, and a copy of this report was left at the facility.