Routine inspection·August 29, 2025

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced, required Annual Inspection. The facility file and personnel report was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to Caregiver Mila Flotildes and Licensee Gus Fernandez. The facility's license shows a maximum capacity of six (6) non-ambulatory residents, one (1) of which may be bedridden. Bedridden resident may reside in bedroom #1 only. Additionally, the facility is approved for two (2) hospice waivers. During today’s inspection there were six (6) residents in care. LPA and Licensee Fernandez 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. Hot water temperature at taps accessible to clients were all compliant: Common bathroom sink in hall restroom was 107.2F and common bathroom sink in the restroom adjacent to the garage measured at 115.7F. 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. The facility contained at least two (2) days of perishable food, and at least seven (7) days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. As LPA was shown the drawer where knives are stored, LPA noted that the lock mechanism was broken, rendering the drawer accessible to residents in care. Staff immediately moved the knives in the drawer to a locked storage room. As a staff member was present and working in the kitchen from when LPA arrived to when the broken lock was noted, a Type B citation was issued as opposed to a Type A for the accessible knives. [Continued on LIC 809-C] [Continued from LIC 809] No toxic chemicals or poisons were accessible to clients.  Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per Licensee Fernandez, no firearms or ammunition are kept at the facility. Smoke and carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguishers were serviced within the last 12 months. First aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed three (3) staff and zero (0) clients, and interviews did not reveal any licensing or regulatory concerns. LPA reviewed facility records. Staff records were offsite due to updating documents and Licensee will send remaining required staff documents to LPA via email. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. One Deficiency was cited during the inspection for the accessible knives. An exit interview was conducted with Licensee Fernandez to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058) were provided. Their signature below confirms receipt of these documents.