Routine inspection·May 17, 2024

Licensing Program Analysts (LPAs) Ryan Fulton and Carmen Lopez conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by and discussed the purpose of the visit to caregiver Mary Cuaresma. The facility's license shows a maximum capacity of six (6) residents, of which four (4) may be non-ambulatory and one (1) may be bedridden. During today’s inspection there were three (3) clients in care. LPAs and Mary Cuaresma, toured the interior and exterior of the facility, and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all of which are safely stored. Cooking/dining equipment and utensils were present. Toxic chemicals/poisons were locked and inaccessible accessible to residents. Medications were labeled, as required, and stored in locked areas. Hot water temperature at taps accessible to clients were all compliant: Kitchen sink was 115.2 F, bathroom #1 sink was 113.2 F and bathroom #2 sink was 117.3 F. No pools or bodies of water exist on the premises. Per caregiver, no firearms or ammunition are kept at the facility. Carbon monoxide/Smoke detectors, emergency lighting, and facility. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. (Continuation on LIC809-C) (Continuation of LIC809) Deficiencies were sited during today’s annual inspection and can be found on the LIC809-D pages of this report. Technical Violations (TV) were provided at today’s inspection. An exit interview was conducted with Caregiver Mary Cuaresma to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit. The signature below confirms the documents were received.