Routine inspection·October 9, 2025

On 10/09/2025, Licensing Program Analyst (LPA) Beena Singh made an unannounced visit to the facility to conduct a required annual inspection. LPA Singh met with staff Josephine Rivera and granted entry to the facility and Administrator, Rolando Serquinia arrived during this visit, and LPA Singh discussed the purpose of this visit. The facility is a Residential Care Facility for the Elderly (RCFE) with a license capacity of (6) and a current census of (4) residents in care. LPA Singh conducted an overall inspection of the facility, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing (CCL). There are no obstructions to indoor and outdoor passageways. The facility is maintained at a comfortable temperature. LPA Singh inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperatures in the bathrooms to be at 115 degrees F The facility is equipped with operating smoke detectors and carbon monoxide alarms and in working condition. Posters such as personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to residents in care. There was a designated storage space for resident/staff files. Overall, the facility is clean, in good repair, and operating in safe conditions for residents in care. Food Service: Facility kitchen and dining areas are maintained clean. The facility has sufficient non-perishable and perishable food supply for residents in care. Facility's refrigerator has sufficient food storage space. Health Related Services: LPA Singh review of medications reveals medications are centrally stored in a locked cabinet and a record of resident medications is maintained at the facility. Personnel/Resident Records: LPA Singh reviewed two (2) staff files and four(4) residents files. The Administrator’s certification is current. Staff records were reviewed for health screenings, criminal record clearances/exemptions, first aid/CPR training certification, and training. Resident files were reviewed for emergency contacts, Admission Agreements, appraisals, medication assessments and plans. Fire and emergency disaster drill was conducted on 09/5/2025. An exit interview was conducted, and this report (LIC809) and (LIC809C) was discussed and provided to Facility Administrator Rolando Serquinia .