Routine inspection·July 17, 2025

Licensing Program Analyst Albert Johnson and Regional Manager Stephenie Doub arrived on 7/17/2025, unannounced to conduct an annual inspection. The Department staff met with A. Cruz and explained the purpose of the visit. The facility is a RCFE with a current census of 88. DEPARTMENT STAFF conducted the inspection using the CARE tool. DEPARTMENT STAFF and Administrator inspected the physical plant including but not limited to the kitchen, bedrooms for residents, bathrooms, laundry area, common areas and backyard area. DEPARTMENT STAFF observed the facility to be free of odor. DEPARTMENT STAFF observed sufficient furniture and lighting throughout the facility. During the tour medications were observed out and accessible to others in two residents rooms (R1 and R2) that self administer medications themselves. DEPARTMENT STAFF observed sufficient seven day non-perishable and two day perishable food supplies. Hot water temperature was measured at 119.5 degrees Fahrenheit, which is within the required range of 105 to 120 degrees. Fire extinguishers 2024 and smoke detectors are current and in compliance with fire safety. DEPARTMENT STAFF observed centrally stored medications locked in the medication rooms and toxin are kept locked and inaccessible to residents. DEPARTMENT STAFF reviewed and compared resident medication vs. resident medication logs. DEPARTMENT STAFF reviewed 15 resident and 7 staff files, including criminal record clearances. All staff are fingerprint cleared and associated to the facility. First aid kit was checked and is complete. Deficiencies were observed and cited on the attached 809 D page during today's visit. A copy of this report was provided and an exit interview was conducted with Alfredo Cruz.