Routine inspection·September 15, 2025

Licensing Program Analyst (LPA) Jessica Cho arrived at the facility unannounced for the purpose of conducting the Required 1-Year annual evaluation using the CARE Inspection Tool. LPA was greeted and granted entry by Caregiver Catherine Ranando and explained the reason for the visit. Administrator (Admin) Joiey Ong arrived shortly after. LPA observed two caregivers on duty providing care to six residents of which one is under hospice care. The Administrator's Certificate expires June 18, 2026 for Administrator Joiey Ong. All staff were fingerprint cleared and associated at the time of the visit. The following was observed during the inspection: This is a single story structure located in a residential neighborhood. Facility operates within the conditions and limitations specified on the license. There are six private resident bedrooms, six resident bathrooms, and one private staff bedroom. All common areas were inspected including the attached two car garage. The residents' bedrooms were appropriately furnished. Beds and bedding supplies were in good condition, adequate lighting was provided, sufficient storage space for each residents' personal belongings were observed. Hospital bed and bed rail orders were present for five out of five residents. Bathrooms were found to be in compliance, clean, and operational. The hot water temperature measured at 110.6, 109.5, 105.1, 106.1, 106.5, and 107.4 degrees Fahrenheit in the resident bathrooms. Toxins, disinfectants, sharps, and medications were secured and inaccessible. LPA observed sufficient two-day supply of perishables and seven-day supply of non-perishable food. The kitchen pantry appeared unorganized. LPA toured the exterior portion of the facility. LPA observed the outdoor passageway is free of obstruction. The exit gates were operational and there were sufficient seating and shading. The fire extinguisher was mounted, charged, and purchased 8/11/25. The auditory devices and smoke/carbon monoxide detectors were tested and operational. LPA observed the emergency food/water in the closet behind the piano. Fire drills were conducted quarterly with the last date on June 28, 2025, however drills are not conducted accounting various emergency scenarios. The Emergency Disaster Plan (LIC610E) is outdated. LPA observed the required 'See Something, Say Something' (PUB475) poster posted in the correct size in the entry way. LPA conducted resident/staff interviews and audited six residents' files and two personnel files in which no discrepancies were found. Medications were audited for two out of six residents. No discrepancies noted. LPA consulted the following: to update the LIC610E using the current form released on (3/19), to conduct drills accounting for different emergency scenarios, and to organize the pantry. Based on the observations made during today's visit, no deficiency is being cited. Advisory Notes are being issued. An exit interview was conducted with Administrator Joiey Ong, and a copy of this report was provided at exit.