Routine inspection·January 30, 2025

Licensing Program Analyst Correia made an unannounced visit to conduct the required One-Year Inspection to ensure substantial compliance with Title 22 regulations. LPA Correia was greeted by Caregiver Melissa Everroad, and identified herself, was granted entry into the facility, and explained the purpose of the visit. The facility is licensed to serve six (6) residents 60 and above; all who may be non-ambulatory and/or receiving Hospice services, and two (2) who are bed-ridden. During today's visit, LPA Correia, accompanied by Caregiver Actub, conducted a facility tour of both indoor and outdoor. LPA also conducted staff, resident, and facility file reviews. The facility temperature was 75 degrees Fahrenheit at the time of the visit. The facility's hot water temperature measured with-in regulation requirements. Disinfectants, cleaning solutions, and poisons were inaccessible to residents in care. All resident rooms were equipped with the required furnishings, lighting, and padded mattress covers. Residents’ bathrooms were equipped with grab bars and nonskid flooring in the resident showers, and bathroom fixtures were operational. LPA observed smoke alarms, and carbon monoxide detectors that were in operable condition. Fire extinguishe rs were last inspected on October 4, 2024. The facility’s outdoor area was free from obstructions, included a shaded area for residents, and sufficient space for activities and visitations. The facility was stocked with a 2-day supply of perishable and 7-day supply of nonperishable food items. The food was observed properly stored. Knives and sharp objects were stored in locked container and were inaccessible to residents in care. Medications were stored in a locked cabinet. [CONTINUED ON LIC 809-C] [CONTINUED FROM LIC 809] The facility's last disaster drill was conducted on 12/13/2024. Licensee Nucom has current Administrator certification. LPA observed a sufficient amount of PPE supplies, and a first aid kit. LPA also observed the required postings. Per Caregiver Actub there are no weapons and/or ammunition housed on the facility premises, nor any bodies of water. Resident and staff records were complete, organized, and up to date. Based on today's visit, there were no deficiencies observed at this time in the areas evaluated. An exit interview was conducted with Caregiver Actub and will be provided with a copy of this report and licensee/appeal rights (LIC 9058 01/16), and their signature on this form acknowledges receipt of these documents.