Routine inspection·May 20, 2025

On 05/20/2025 at 8:30am, Licensing Program Analyst (LPA) Pang Lee and Shakaricka Hughes arrived at the facility to conduct an unannounced annual inspection. LPA's met with administrator Emelita Madriaga and explained the purpose of the visit. The current census is 4 with 4 facility staff. This facility is a single story building licensed to serve (2) non-ambulatory and (2) ambulatory residents. LPA's 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's observed the facility to be free of odor, clean and in good repair. LPA's observed bedrooms to be properly furnished with appropriate bedding and lighting. There are no bodies of water present. LPA's toured the kitchen and observed sufficient seven-day non-perishable and two-day perishable food supplies. Hot water temperature was measured at 120.2 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 the kitchen area and was last serviced on 07/05/2024. LPA's observed the facility has a public telephone in the dining area and the facility has the required posters posted. Facility thermostat was observed at 73 degrees Fahrenheit. LPA's observed toxins located in the hallway closet and kept locked and inaccessible to residents. LPA's observed sharp knives kept locked in the kitchen and inaccessible to residents. Continuation 809-C LPA's checked medication storage and found medication to be locked away and inaccessible to residents. LPA reviewed 2 out of 4 residents medications and the medication administration record (MAR) was complete. During today's visit it was learned that administrator pre-doses medications. Administrator states, at the last annual inspection they were not advised that pre-dosing medication was a non-compliance issue. The first aid kit was checked and contained the required components. LPA's requested resident and staff files for review. LPA's reviewed 4 out of 4 resident files and they were complete. LPA's reviewed 3 out of 3 staff files and it was complete. LPA's 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 end of day today 5:00 PM: (1) LIC 610 Current Emergency Disaster Plan As a result of this annual visit, the facility is in compliance with Title 22 Regulation. An exit interview was conducted with Emelita and a copy of these LIC 809, LIC 809-C, and LIC 9102-TV pages, were provided to the facility.