Routine inspection·September 8, 2025

Licensing Program Analyst (LPA) Abdoulaye Zerbo conducted an unannounced visit for a required annual inspection . The LPA was greeted by Caregiver Andrea Oda, notified them of the purpose for the visit and was allowed to enter the facility to conduct the inspection. Licensee/Administrator Aron Oda joined the visit at a later time. Facility Overview: The facility is a single- story building with 3 residents' bedrooms, 1 bathroom, a dinning room, a living room, a kitchen, a laundry room (Upstairs), 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 the kitchen and inaccessible to residents. The smoke detectors and carbon monoxide detectors were operable. LPA observed fire extinguisher to be in compliance with the department's requirements and with an expiration date of 09-08-2026. The water temperature was tested within regulations measuring 111.7 F Continued 809-C...... Care & Supervision/Administration: Adequate staff were present to supervise residents during the visit. The Administrator holds a current Administrator’s certificate with the expiration date of 01-04-2027 and CPR certification with the expiration date of 09-01-26 Record Review and Resident/Staff Files: LPA reviewed files for 2 staff members, confirming criminal clearance, updated training, and health screening. 3 residents' files were reviewed and contained all required documentation. LPA observed first kit to be available for the residents in care. The residents and staff files were kept locked and inaccessible to unauthorized individuals. Health-Related Services/Incidental Medical Services: All residents' medications were securely locked in a cabinet and located in the kitchen. LPA reviewed medications for 3 residents confirming that all medication were listed and accounted for. Information obtained after records review and interviews revealed the facility is not approved for bedridden but admitted R3 who is bedridden. Citation will be issued Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan, including documentation of the last emergency drill conducted on 07-06-2025, which met the department's requirements. All facility exits were clear of obstructions. Due to a zero tolerance for unapproved fire clearance, the facility is being assessed an immediate civil penalty in the amount of $500, as they are operating without the proper fire clearance. An exit interview was conducted where a copy of this report 809C, 809D, appeal rights, LIC421IM was reviewed and provided to Administrator Licensee/Administrator Aron Oda.