Routine inspection·April 17, 2025

Licensing Program Analyst (LPA) Ramon Serrano conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was allowed entry and discussed the purpose of the visit with Administrator Rodolfo Tabladillo and Licensee Edna Tabladillo joined a short time after. According to the facility’s license, the facility has a maximum capacity of six (6)residents. All of whom may be non-ambulatory. LPA, accompanied by Administrator toured the interior and exterior of the facility, and inspected each room. LPA encountered mice droppings in the linen closet located on the first floor, adjacent from the kitchen. Both the hot water temperature and the facility ambient temperatures were at compliant readings. 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. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to clients. Medications were labeled, as required, and stored in locked areas. .Per Administrator, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were present. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. [CONTINUED ON LIC 809-C] LPA reviewed multiple staff, resident and facility records/files. Records review revealed no current facility liability insurance on file. Records review further revealed facility staff did not meet the 20 hours of yearly training required by the Department. Licensee confirmed that she is currently in the process of obtaining liability insurance. Licensee also stated that her along with the facility staff have conducted the yearly training but it has not been documented. Confidential records were stored in locked areas. Based on interviews, observations, and record review, deficiencies were observed and cited on the attached LIC 809D. An exit interview was conducted with Rodolfo Tabladillo whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.