Routine inspection·August 11, 2025

Licensing Program Analyst (LPA) Jessica Cho arrived 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 Nancy Villanueva and explained the reason for the visit. Supervisor John Bardon arrived approximately 10:25am to assist with the inspection. Administrator Brian Schott holds a valid certificate expiring on July 3, 2026. The facility is a single story structure and is licensed to provide services for age range 60 and over for six ambulatory residents of which six may be non-ambulatory. A waiver was granted to provide hospice services to six residents at one time. During today's visit, there are three residents under hospice care and three staff on duty. LPA toured the physical plant with Caregiver Villanueva. During the inspection, LPA observed the following areas requiring a deep cleaning and repair: the interior and exterior kitchen cabinets and appliances had evidence of grime and oil residue that require a deep cleaning, pantry needs to be reorganized, cleaned, and relined with a shelf liner, and the fire alarm pull station panel was half detached that needs to be reattached. LPA observed five resident bedrooms and three resident bathrooms. There is one additional staff bedroom occupied by four live in staff. Resident bedrooms had all required furnishings. Bathrooms were found to be in compliance, clean, and operational. The hot water temperature measured at 117.5, 115.7, and 113.7 degrees Fahrenheit. All common areas were inspected including the two car garage. LPA reviewed the Emergency Disaster Plan (LIC610E) and observed sufficient emergency food and water in the garage. 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 available in the kitchen. LPA toured the exterior portion of the facility. The outdoor passageway is free of obstruction. The exit gate is self-closing and self-latching. LPA observed sufficient seating and shading. The fire extinguisher was purchased on December 17, 2024 per the Home Depot purchase receipt. The auditory devices and smoke/carbon monoxide detectors were tested and operational. Emergency evacuation drills are conducted quarterly, with the last date on April 23, 2025. The Complaint Poster, 'See Something, Say Something,' (PUB 475) was available and posted in the correct size in the entryway. LPA conducted a review of all residents and three staff files. No discrepancies noted. Medications for four out of four residents were audited and no discrepancies were noted. Interviews were successfully conducted or attempted with four residents as well as two staff interviews. Based on the observations made during today's visit, no deficiencies are being cited. Technical Violations are being issued. An exit interview was conducted with Supervisor John Bardon, and a copy of this report was provided at exit.