Routine inspection·November 28, 2023

Licensing Program Analyst (LPA) Dawn Segura conducted an unannounced Required Annual Inspection. LPA introduced herself and was granted entry into the facility by Elizabeth Fetene, to whom LPA disclosed the purpose of the visit. According to the facility’s license, the facility is licensed for a maximum capacity of six (6) residents, four (4) of whom may be non-ambulatory. During today’s inspection, there were no (0) residents in care. LPA, accompanied by Elizabeth, toured the interior and exterior of the facility, and inspected each resident room. The facility was clean and in good repair. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors and equipment inspected were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. Hot water temperature at sink accessible to residents measured at 103.4 degrees Fahrenheit. Refrigerators and freezers were operational and had sufficient space to store perishable items. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible. No pools or bodies of water were observed on the premises. LPA was advised that no firearms or ammunition are stored in the facility. Smoke alarms and carbon monoxide detectors were in working order. Fire extinguishers were present. Required licensing postings were posted in a visible area of the facility. No deficiencies were cited during today's annual inspection. An exit interview was conducted with Elizabeth Fetene, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided at the end of the visit.