Routine inspection·March 3, 2022

Licensing Program Analyst (LPA) Anthony Tuck arrived to conduct an unannounced annual/random inspection on 03/03/2020. LPA met with staff Clemente Madriaga and Licensee Emilita Madriaga and explained the purpose of the visit. Emilita Madriaga is also the Administrator and holds certificate #6004809740 that expires on 07/17/2023. This facility is a single story building licensed to serve six (6) ambulatory residents of which 2 may be non ambulatory at any given time. LPA toured the physical plant including but not limited to two resident bedrooms, two resident bathrooms, garage and backyard area. LPA observed the facility to be free of odor, clean and in good repair. LPA observed sufficient furniture and lighting throughout the facility. There are no bodies of water present. LPA observed sufficient seven day non-perishable and two day perishable food supplies. Hot water temperature was measured at 106.9 degrees Fahrenheit in resident bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Fire extinguishers and smoke detectors are in compliance with fire safety. Fire extinguisher last serviced of 07/14/2021. Thermostat was 68 degrees Fahrenheit. LPA observed centrally stored medications and toxins was kept locked and inaccessible to clients. LPA reviewed staff associations and fingerprint clearance to the facility. First aid kit was checked and is complete. The following forms need updating and were collected during today's visit on 03/30/2022: LIC 9020, Copy of current administrator certificate, copy of certificate of liability insurance, LIC 500 No deficiencies were cited during today's visit. Exit interview held with Emelita Madriaga and a copy of report given at the conclusion of the visit.