Routine inspection·November 7, 2025

On November 7, 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 Rose Ang to notify of visit. Administrator Rose Ang arrived at 9:07AM and was available to assist with the facility inspection. The facility is licensed for five (5) non-ambulatory and one (1) ambulatory residents with approved hospice waiver for four (4) residents. Facility serves as a Residential Care Facility for the Elderly and Dementia. Currently, there are two (2) Hospice residents present during today’s visit. This is a single story with attached garage facility. The facility has five bedrooms (two private resident rooms, two shared resident rooms and one staff room) and two resident bathrooms and one staff bathrooms. At around 9:15AM , LPA conducted a tour of the physical plant accompanied by Administrator Rose Ann Ang, 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 105.8 to 118.9 degrees F in resident restrooms. 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 personal hygiene, cleaning products and sharps objects were stored and not accessible to residents. CONT. on 809C 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. Facility has one fire extinguisher which was 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 screening protocols for visitors, staff and residents. LPA observed the facility has supply of Personal Protective Equipment (PPE). Facility has mandated inspection control posters posted. LPA observed First Aid Kit was maintained. A working landline phone was operational. The last fire drill was conducted on August 31, 2025. The facility had operational smoke and carbon monoxide detectors in bedrooms and common areas. The facility has current liability insurance on file effective August 11, 2025 – August 11, 2026. A review of four residents (R1-R4) service files and three staff (S1-S3) personnel files revealed to be complete. The facility has the current administrator's certification on file for Rose Ann Ang– Expiration August 3, 2026. No deficiencies during this inspection visit. An exit interview was conducted with Administrator Rose Ann Ang, and a copy of the report was provided.