Routine inspection·October 2, 2025

On 10/2/2025 at 9:15 AM, Licensing Program Analyst (LPA) Shakaricka Hughes arrived at the facility to conduct an unannounced annual inspection. LPA met with administrator Veronica Dawson. LPA explained the purpose of the visit. The current census is 8 with 1 facility staff. This facility is a single story building licensed to serve twelve (12) ambulatory residents only. LPA inspected the physical plant including but not limited to the common area, kitchen, dining area, resident bedrooms, resident bathrooms, laundry room and outside courtyards of the facility to ensure compliance with Title 22 regulations. LPA observed the facility to be free of odor, clean and in good repair. LPA observed bedrooms to be properly furnished with appropriate bedding and lighting. LPA toured the kitchen and observed sufficient seven-day non-perishable and two-day perishable food supplies. LPA observed knifes kept and made inaccessible to residents in care. Hot water temperature was measured at 115.1 degrees Fahrenheit in resident bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Grab bars and non-slip mat were observed to be stable and in good repair at this time. Smoke and carbon monoxide detectors are in compliance with fire safety. The fire extinguisher is located in kitchen and hallway of the facility. The fire extinguisher was last serviced on 08/01/2025. LPA observed the facility has a public telephone in the dining room. Facility thermostat observed at 75 degrees Fahrenheit. LPA observed toxins kept locked and inaccessible to residents. LPA checked medication storage and found medication to be locked away and inaccessible to residents. The first aid kit was checked and contained all of the required components. Continuation 809-C LPA checked medication storage and found medication to be locked away and inaccessible to residents. LPA reviewed 2 out of 8 residents medication records, and observed the Resident Centrally Stored Medication and Destruction Record (CSMDR) were not maintained in resident files for 6 out of 8 residents in care. LPA reviewed 6 out of 8 resident files and they were not complete. Resident file for resident (R5) was observed incomplete as the resident's LIC 602A Physician's Report was missing from the resident's file. Licensee stated the facility is still awaiting the completed report from the resident's placement agency and physician's office. LPA requested staff files for review and they were complete. LPA reviewed staff criminal record clearances, and a review of staff records indicates that all facility staff or other individuals who require caregiver background checks are fingerprint cleared. The following documents will be email to LPA by 10/2/2025 end of day 5:00 PM: (1) LIC 308 Designation of Administrative Responsibility (2) Copy of Administrator Certificate (3) LIC 610 Current Emergency Disaster Plan (4) Proof of Current Liability Insurance (5) LIC 500 Current Personnel Report As a result of this annual visit, the facility is not in compliance with Title 22 Regulations, and the deficiency can be found on the LIC 809-D and LIC 9102 pages. An exit interview was conducted with Veronica and a copy of the LIC 809 reports, LIC 809-D, LIC 9102 , and Appeals rights were provided to the facility.