Routine inspection·September 25, 2025

On September 25, 2025, Licensing Program Analyst (LPA) Jenifer Tirre conducted an unannounced required visit using the CARE Inspection Tool. LPA was greeted by staff and granted entry after stating the purpose of the visit. Staff contacted Administrator Dianna Manalo who arrived shortly after to assist with inspection. The facility is licensed for five (5) non-ambulatory residents, one (1) bedridden with approved hospice waiver for four (4) residents. Currently, there are two (2) Hospice residents present during today’s visit. This is a single story with attached garage facility. The facility has four private resident rooms, one shared resident room, one staff room and two full bathrooms. At around 9:00AM, LPA conducted a tour of the physical plant accompanied by Administrator Dianna Manalo, 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 in facility closet during the visit. Bathrooms were operational with water temperature measured at 109.0 degrees F. A comfortable temperature of 75 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 supplies, sharps objects, and cleaning supplies were secured and not accessible to residents. CONTINUED ON 809C The kitchen was inspected, and sufficient two day perishables and Seven day non-perishable food was maintained. Facility has emergency food and water. Facility has three fire extinguishers which were mounted and fully charged. 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 the facility has supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. LPA observed First Aid Kit was maintained. A working landline phone was operational. The last fire drill was conducted on 7/25/2025. The facility had centrally wired operational smoke and carbon monoxide detectors in bedrooms and common areas. The facility has current liability insurance on file effective 8/6/2025 – 8/6/2026. A review of six residents (R1-R6) service files and three staff (S1-S3) personnel files revealed to be complete. The facility has the current administrator's certification on file for Dianna Manalo - Expiration 11/15/2025. No deficiencies during this inspection visit. An exit interview was conducted with Administrator Dianna Manalo, and a copy of the report was provided.