Routine inspection·June 4, 2025

On June 4, 2025, Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced required visit using the CARE Inspection Tool. LPA Tirre was greeted by staff and granted entry after stating the purpose of the visit. Assistant Administrator (AD) Maria Tavarez arrived shortly after and was present to assist with the facility inspection on today's date. The facility is licensed for six (6) non-ambulatory residents of which six (6) may be bedridden with approved hospice waiver for six (6) residents. Currently, there are five (5) Hospice residents and two (2) bedridden residents present during today’s visit. This is a single story home with a attached two car garage facility. The facility has six private resident bedrooms and six full bathrooms and one half bathroom. At around 12:30 PM, LPA Tirre conducted a tour of the physical plant accompanied by Assistant Administrator Maria Tavarez, and the following was observed: There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the client's personal belongings was observed. Bed linens, comforters, and bath towels were available during the visit. Bathrooms were operational with water temperature measured at 114.8 degrees F. A comfortable temperature of 78 degrees F. was maintained in the facility. LPA observed the facility to be furnished at the time of the visit. Storage areas for personal hygiene, cleaning supplies and sharps objects were stored and not accessible to residents. CONTINUED ON 809C The kitchen was inspected, and sufficient 2 day perishable and 7 day non-perishable food was maintained adequately. Fire extinguishers were charged and mounted. Facility has 2 fire extinguishers. A review of the Medication Records Administration (MAR) was conducted, and LPA observed the records are in compliance. During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents. LPA observed sanitizing stations in common areas and restrooms. LPA observed the facility has a supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. LPA observed First Aid Kit was maintained. A working land line phone was operational. The last fire drill was conducted on June 3, 2025. The facility had operational smoke and carbon monoxide detectors in bedrooms and common areas. The facility has current liability insurance on file effective 8/1/2024 – 8/1/2025. A review of six residents (R1-R6) service files and two staff (S1-S2) personnel files revealed to be complete. The facility has the current administrator's certification on file for Julio Navallo # 7025486740 - Expiration 8/31/2025 No deficiencies during this inspection visit. An exit interview was conducted with Assistant Administrator Maria Tavarez, and a copy of the report was provided.