Routine inspection·July 26, 2023

Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a Required 1-year inspection. LPA met with Caregiver, Cadine Jackson, and explained the purpose of the visit. Caregiver then contacted Administrator, John Paul Pamintuan, who arrived shortly to the facility. The facility has (6) residents, (1) on hospice services, facility is licensed for (6) with hospice waiver of (2). LPA and Administrator toured the interior and exterior of the facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, (6) resident bedrooms, (1) common bathroom, kitchen, laundry room and staff room. In the areas toured no immediate health, safety, or personal rights violations were observed. During today's inspection, LPA observed a sharps, medication and toxins to be locked and secured. LPA observed facility temperature to be 71*. LPA observed fire extinguisher to last be serviced on 01/09/2023. LPA obtained a copy of Administrator Certificate and liability insurance. LPA requested: LIC 500 and client roster. Documents to be submitted to LPA via email by due date on Friday August 4, 2023. LPA conducted a file review of (2) staff and (2) resident records. LPA and Administrator completed the full CARE tool together and found facility to be in compliance. Exit interview conducted and copy of report was left at the facility.