Routine inspection·December 28, 2023

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Required Annual Inspection. The LPA introduced himself and discussed the purpose of the visit with Caregiver Elena Razo. Licensee Yanet Puentes arrived during the visit and assisted the LPA. The facility was licensed for a capacity of six (6), approved for six (6) non-ambulatory residents, and a hospice waiver of four (4). At the time of the visit the facility had a census of three (3). The LPA 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 obstructions and slip hazards. Resident bedrooms contained the required furnishings, including personal storage space and linens. There was at least 2 days of perishable food, and at least 7 days non-perishable food present. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to residents. Medications were labeled, and stored in a locked area. No pools or bodies of water on the premises. Per staff, no firearms, nor ammunition were kept at the facility. Carbon Monoxide, fire extinguisher(s), and required licensing postings were observed in visible areas. LPA interviewed staff and reviewed multiple staff and resident records. Some of the required records were not present at the time of the visit. These deficiencies were cited an LIC 809D and a plan of correction was jointly formulated with the Administrator. An exit interview was conducted with licensee Puentes, to whom a copy of this report, the LIC 9099D, LIC 811, and the Licensee/Appeal Rights (LIC9058), were provided.