Routine inspection·June 20, 2025

Licensing Program Analyst (LPA) Abdoulaye Zerbo conducted an unannounced visit for a required annual inspection . The LPA was greeted by Caregiver Vivian De Peralta, notified them of the purpose for the visit and was allowed to enter the facility to conduct the inspection. Facility Overview: The facility is a single story building with 4 residents' bedrooms, 1 staff bedroom, 2 bathrooms, a dinning room, a living room, a kitchen, an office, an outdoor area, and a garage. There is no gated pool and there are no firearms on the premises. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility’s infection control plan was reviewed and found to meet department's requirements. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked in a cabinet in the kitchen and inaccessible to residents. The smoke detector and carbon monoxide detector were operable. The fire extinguishers were not in compliance with the department's requirements and were last inspected 12-04-2023. The water temperature was tested and did not fall within regulations measuring 148.5 F. Citations will be issued Continued 809-C...... Care & Supervision/Administration: Adequate staff were present to supervise clients during the visit. The Administrator holds a current Administrator’s certificate with the expiration date of 08-01-2026 and a CPR certification with the expiration date of 01-09-2027. Record Review and Resident/Staff Files: LPA reviewed files for 2 staff members, confirming criminal clearance, updated training, and health screening. 2 residents' files were reviewed and contained all required documentation. LPA observed first kit to be available for the residents in care. The clients and staff files were kept locked in a cabinet in the kitchen area and inaccessible to unauthorized individuals. Health-Related Services/Incidental Medical Services: All residents' medications were securely locked in the kitchen area. LPA reviewed medications for 2 residents confirming that all medication were listed and accounted for. Disaster Preparedness: The facility did not have a copy of the emergency and disaster plan as well as copies of the required quarterly emergency drills. Citations will be issued An exit interview was conducted and a copy of this report, 809D, and the appeal rights were reviewed and provided to Caregiver Vivian De Peralta.