Routine inspection·November 14, 2025

Licensing Program Analysts (LPAs) Seo Jeon and Jacqueline Shaw-Ross conducted an unannounced annual required visit. Upon entry, LPA was greeted by Marcelina Quintana, Caregiver, and informed them of the purpose of the visit. At the time of the visit, there were two (2) staff members and three (3) residents present. Alicia Pergantis, the Administrator, arrived at the facility at 3:30 PM. Facility Overview: The facility is a one-story home with (4) bedrooms and (2) bathrooms, including an attached garage. There are no pools or known firearms on the premises. Infection Control: LPA observed that hygiene and cleaning supplies were available for regular facility maintenance. The facility has infection control plan in file. Physical Plant: The physical plant, including floors, windows, and doors, was clean and well maintained. Fixtures and furniture were in good repair. The outdoor area was free of hazards. Laundry equipment was in good working condition. Sharp and dangerous objects were securely locked and inaccessible to residents. Both the smoke detector and carbon monoxide detector were operational, and the hot water temperature was 107°F. Fire extinguisher located at dining area is new purchase. LPAs observed one (1) gallon insecticide on garage floor which was accessible to residents in care. Entrance door to the garage was not key locked which made the garage accessible to anyone in the home. A citation was issued. Continued on LIC809-C..... Food Service: The facility’s kitchen was clean and equipped to prepare food. The facility maintained the required two-day supply of perishable foods and a seven-day supply of non-perishable foods. Care & Supervision/Administration: Adequate staff were present to supervise clients during the visit. The administrator holds a current administrator’s certificate. Record Review and Resident/Staff Files: LPA reviewed files for two (2) staff members, confirming criminal clearances, updated training, and CPR/First Aid certification. Three (3) resident files were reviewed and contained all required documentation. Health-Related Services/Incidental Medical Services: All resident medications were securely locked. LPA reviewed medications for three (3) residents, confirming that all medications were listed on the Medication Administration Record (MAR) and accounted for. Disaster Preparedness: LPA reviewed the facility’s emergency and disaster plan, including documentation of the last fire drill conducted on 10-10-2025, which met department requirements. All facility exits were clear of obstructions. One citation was issued during the visit. An exit interview was conducted, during which this report was reviewed and provided along with LIC809-D and Appeal Rights.