Routine inspection·February 5, 2026

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, one of which may be bedridden. The facility currently has six residents admitted and all were present during the visit. There are a total of five bedrooms and two restrooms available. I bedroom is currently vacant. 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 was measured at 119.3 degrees F. Kitchen: 4 of 4 burners and the warmer is operational on the gas stove. Sharps are kept locked cabinet near the sink. Cleaning solutions are stored in a locked cabinet below the sink. 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 a locked cabinet across from the dining table. 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 a locked medication cabinet in the kitchen. Medication Review: 3 of 5 resident medications were reviewed during the visit. No discrepancies were noted. Medication is being administered as prescribed. Continued on LIC809C Linens & Hygiene Supplies: Resident hygiene items were observed in a locked cabinet below the sink in the main bathroom. Garage Area: The garage is organized and used mainly as a storage area. A washer and dryer was observed. An additional refrigerator with a nonperishable food supply was observed. Miscellaneous resident care items were observed: wheelchair, bedframes. Backyard/Exterior: The backyard is clean and organized. Walkways are free of obstruction. A table with some chairs was observed under a large sunshade. Bodies of Water: None. Smoke/Carbon Monoxide Detectors: Smoke and carbon monoxide detectors tested operational. Fire Extinguisher: Fire extinguisher was observed mounted on a wall near a sliding door that leads to the backyard. An emergency evacuation drill: January 1, 2025. Evacuation drills are conducted monthly. Emergency Phone Numbers, House Rules, Exit Plan & Menu: Several facility postings are posted, and available for review on the main postings board across from the dining table. Additional Comments: Licensing fees were paid during the visit, and a copy receipt was provided. Facility contact information was reviewed during the visit and a new mobile number was provided. Facility representative was advised to watch the hot water temperature as the hot water temperature almost reached 120 F. No deficiencies are being cited during today’s visit. An exit interview conducted, and a copy of the report was provided.