Routine inspection·July 10, 2024

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Required Annual Inspection. The LPA introduced himself and disclosed the purpose of the visit to Administrator Diep Malmberg. The facility was licensed for a capacity of six (6) non-ambulatory residents and approved for a hospice waiver for four (4) residents. The LPA, accompanied by the administrator, 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. Doors, windows, screens, toilets, and showers were in working order. 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 safely stored. Cooking and 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 or ammunition are kept at the facility. A Carbon monoxide detectors, emergency lighting, and Fire extinguisher were present. The LPA reviewed resident records. No immediate health, nor safety concerns were observed, nor cited on today's date. Due to time constraints, a return visit on a subsequent day is needed to complete the annual inspection. An exit interview was conducted with Administrator Diep Malmberg, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058) were provided via electronic mail. An electronic mail read receipt confirms the documents were received by Malmberg.