Routine inspection·September 26, 2025

Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified herself to, and discussed the purpose of the visit with Caregiver Emelita Supnap. Administrator Cheryl Castro arrived shortly after. According to the facility’s license, the facility has a maximum capacity of six residents, of whom all may be non-ambulatory. LPA toured the interior and exterior of the facility and inspected each room. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, toilets, and showers were in working order. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. All windows were checked and there was only one window screen that needed to be repaired. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to residents. No pool or body of water is present. Per Administrators, no firearms or ammunition are kept at the facility. The smoke and carbon monoxide detectors, as well as the fire extinguisher, were inspected by the local Fire Department in February 2025. The facility telephone was tested and is working. Emergency lighting and first aid kits were observed and accessible to staff. Water temperatures for bathrooms accessible to residents were in compliance.. The facility’s ambient internal temperature was comfortable. Medications were labeled, as required, and stored in inaccessible areas. Resident records reviewed had required documentation. (CONTINUED ON LIC 809C, NEXT PAGE) (CONITNUED FROM FIRST PAGE, LIC 809) Resident and staff records reviewed had required documentation. The First Aid training cards for the Care Staff were expired and staff require completion of the training. Residents and staff were interviewed, there were no health and safety concerns from the interviews. All records were stored in a locked area. No citations were issued during this visit. A technical violation was issued. An exit interview was conducted with Cheryl, to whom a copy of this report, LIC 9099-D, LIC9102 and the Licensee/Appeal Rights (LIC 9058 03/22) were provided to Cheryl. ***NOTE: LPA left the facility for a 1 hour lunch break and returned to complete the inspection.