Routine inspection·February 19, 2026

On 02/19/2026, Licensing Program Analyst (LPA) Pang Lee arrived at the facility to conduct an unannounced annual inspection. LPA Lee met with care staff Chat Halasz and explained the purpose of the visit. The care staff called Administrator Erica Panen to inform her that Community Care Licensing (CCL) was present. The Administrator was not able to attend the visit and had the care staff Halasz signed the report. The current census is three with one facility staff. This facility is a single-story building approved for six (6) non-ambulatory residents of which one (1) may be bedridden in bedroom #3 and granted for hospice care for two residents. LPA Lee inspected the physical plant including but not limited to the common area, kitchen, dining area, resident bedrooms, resident bathrooms, garage and outside courtyards of the facility to ensure compliance with Title 22 regulations. LPA Lee observed the facility to be free of odor, clean and in good repair. LPA Lee observed bedrooms to be properly furnished with appropriate bedding and lighting. There are no bodies of water present. LPA Lee toured the kitchen and observed sufficient seven-day non-perishable and two-day perishable food supplies. Hot water temperature was measured at 111.0 degrees Fahrenheit in resident bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. The smoke and carbon monoxide detectors are in compliance with fire safety. The fire extinguisher is located in the kitchen and was last serviced on 11/04/2025. LPA Lee observed the facility has a has a public telephone in the dining room and the facility has the required posters posted. CONTINUED LIC 809-C Facility thermostat was observed at 70 degrees Fahrenheit, which is within the required regulation of 68 to 85 degrees Fahrenheit. LPA Lee observed toxins located in the kitchen cabinet and kept locked and inaccessible to residents. LPA Lee observed sharp knives kept locked in the kitchen cabinet and inaccessible to residents. LPA Lee checked medication storage and found medication to be locked away and inaccessible to residents. The first aid kit was checked and contained the required components. LPA Lee reviewed three out of three resident files, and they were complete. LPA Lee reviewed 2 staff files and they were also complete. Furthermore, today’s visit was also conducted in response to an incident report that occurred on 01/02/2026 through 01/06/2026 and was received by the Department on 01/20/2026. Based on the incident report and interviews with Administrator Panen and care staff Halasz, Resident 1 (R1) was administered Digoxin 125 mg incorrectly. The physician’s order states that R1 is to receive one tablet by mouth every two days; however, staff administered one tablet daily for five consecutive days. LPA Lee audited the medications for three out of three residents by comparing the medications on hand with the Medication Administration Records (MARs) and confirmed that all records were accurate and 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 and associated with the facility. The following documents will be emailed to LPA Lee by 02/26/2026 at the end of day at 5:00 PM. (1) LIC 308 Designation of Administrative Responsibility (2) Copy of Administrator Certificate (4) LIC 610 Current Emergency Disaster Plan (5) Proof of Current Liability Insurance (6) LIC 500 Current Personnel Report As a result of this annual visit, the facility is not in compliance with Title 22 Regulation, and the deficiency can be found on the LIC 809-D page. An exit interview was conducted with care staff Halasz and a copy of these LIC 809 reports, LIC 809-D page, and Appeals rights were provided to the facility.