Routine inspection·July 31, 2025

Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced required annual inspection. The facility file was reviewed prior to the visit. LPA Silveira identified herself, disclosed the purpose of the visit and was granted entry by Administrator Regina Jackson. According to the facility’s license, the facility is licensed to serve six (6) non-ambulatory elderly residents, one of whom may be bedridden at any time. All bedrooms are approved to house the bedridden resident. Hospice waiver approved for six (6). LPA, accompanied by Regina, 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, 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 activities. Hot water temperature at taps accessible to clients in bathrooms were also complaint: sink #1:115.5 F, sink #2: 114.1 F, sink #3: 117.2 F. 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, and all safely stored. There were no toxic chemicals or poisons accessible to clients. Medications were properly labeled, as required, and stored in locked room which LPA inspected. No pools or bodies of water on the premises. Per Regina, there are no firearms or ammunition kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] Fire extinguisher was present (01) and serviced within the last 12 months. First aid kit was complete and readily accessible. LPA reviewed staff and client records. LPA’s visit did not raise any licensing concerns. The files which LPA reviewed contained required documents. Confidential records were stored in a locked cabinet. Required licensing postings were observed in a visible area of the facility. There were no deficiencies observed or cited during today's annual inspection. An exit interview was conducted with Regina, to whom a copy of this report along with the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit. The signature below confirms the documents were received.