Routine inspection·September 10, 2025

On September 10, 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. House Manager/ Administrator Glen Navarro was not available to assist with the facility inspection. Staff contacted Administrator to notify of visit. The facility is licensed for six (6) non-ambulatory residents, which one (1) may be bedridden with approved hospice waiver for six (6) residents. Currently, there are four (4) Hospice residents present during today’s visit. This is a single story home with attached garage facility. The facility has six private resident bedrooms, and two full bathrooms At around 12:15PM, LPA conducted a tour of the physical plant accompanied by Caregiver Maria Labos, 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 between 107.9 to 110.6 degrees F. A comfortable temperature of 74 degrees F. was maintained in the facility. LPA observed the facility to be furnished at the time of the visit. Storage areas for cleaning supplies and sharps objects were stored and not accessible to residents. The kitchen was inspected, and sufficient two day perishable and seven day non-perishable food was maintained adequately. Facility has supply of emergency food and water. CONTINUED ON 809C Facility has one fire extinguisher was mounted and charged. Backyard has shaded seating area for residents and visitors. 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. 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 February 17, 2025. The facility had operational smoke and carbon monoxide detectors in bedrooms and common areas. A review of six residents (R1-R6) service files and four staff (S1-S4) personnel files were reviewed. The facility has the current administrator's certification on file for Jennifer Ghahyasi-Brower verified on active pending list # 7018829740. No deficiencies during this inspection visit. A Technical Advisory regarding resident records was issued. An exit interview was conducted with Caregiver Labos, and a copy of the report was provided.