Routine inspection·September 29, 2025

Licensing Program Analyst (LPA) Jerome Haley conducted an unannounced visit for the purpose of conducting a required one-year annual inspection. LPA was greeted, granted entry by staff and explained the reason for the visit. Structure: The facility is a single level structure and licensed for six non-ambulatory residents. As of today, the facility has six residents admitted to the facility. All of the residents were present during the visit, except one resident who is currently in a Skilled Nursing Facility (SNF) and is expected to returned once released. There’s a total of 4 bedrooms and 3 bathroom areas for residents. There’s a living room space, a dining space and an attached garage. Bedrooms: All bedrooms have the required furnishings: bed, lamp, chair, and storage space. Bathroom(s): Bathrooms are equipped with a working toilet, wash basin, and shower. Hot water measured in between 110.4 – 111.5 degrees F. Kitchen: 4 of 4 burners and are operational on the gas stove. Sharps are kept locked in the medication cabinet. Cleaning chemicals are stored below the sink in a locked cabinet. Food Service: A supply of perishable and non-perishable food items that meet regulation requirements was observed. Client & Staff Files : Resident and staff files stored in the locked office area in a locked filing cabinets. File Review: 3 of 5 resident files were reviewed during the visit, and 3 staff files were reviewed. Medications/First-Aid Kit: Resident medications are stored in the kitchen in a locked cabinet. 2 first aid kits were observed in the locked office area. Medication Review: 3 of 5 resident medications were reviewed during the visit. Continued on LIC809C Linens & Hygiene Supplies: Hygiene items were observed in the bathroom areas. Garage Area: The garage is organized, and walkways were free of obstruction. A washer and dryer was observed. Detergents and chemicals are stored in the garage. Two additional refrigerators were observed. One for staff and one for residents. Additional perishable and nonperishable food items were observed. A supply of emergency water was observed. Miscellaneous facility items are being stored in the garage: mattresses, wheelchairs, and incontinent care supplies to name some of the items observed. Backyard/Exterior: The backyard is clean and organized. Walkways are free of obstruction. A table with a sunshade and chairs was observed. Bodies of Water: None. Smoke/Carbon Monoxide Detectors: Smoke and carbon monoxide detectors tested operational. Fire Extinguisher: Fire extinguisher was observed mounted in the kitchen. An emergency evacuation drill: Evacuation drills have not been conducted. Emergency Phone Numbers, House Rules, Exit Plan & Menu: Facility postings are posted are available for review on the main postings board near the dining table. Additional Comments: Licensing fees are current. During the visit, 3 of 5 resident files were reviewed, 3 of 5 resident medications was reviewed and 3 staff files were reviewed during the visit. During the visit facility contact information was updated and confirmed. An exit interview conducted, and a copy of the report and appeal rights were provided.