Routine inspection·October 29, 2025

Licensing Program Analyst (LPA) Liliana Silveira conducted an unannounced required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit with Caregiver and Co-Administrator Sara Fetene. According to the facility’s license, the facility serves four (4) elderly residents, age 60 and above, 4 of whom may be non-ambulatory. The facility has an approved hospice waiver for two (2) residents. During today's inspection, there were a total of (2) two residents in care, and per medical records, both residents were ambulatory. This facility does not feature a secured perimeter or delayed egress doors. LPA, accompanied by Sara, 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. Bedrooms contained the required furnishings. Doors, windows and screens, 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 residents activities. The facility’s ambient internal temperature was comfortable and in compliance. Hot water temperature at taps accessible to residents were all compliant. There was at least 2 days of perishable food, and at least 7 days of non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no sharp objects, toxic chemicals/poisons, fireplaces, or open-faced heaters accessible to residents. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water were observed on the premises. Per Sara Fetene, no firearms or ammunition are kept at the facility (CONTINUED ON NEXT PAGE, LIC 809-C). (CONTINUED FROM PAGE 1, LIC 809) Smoke alarms, carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed one (1) staff and two (2) residents. The interviews did not raise any significant licensing concerns. The reviewed files contained required documents. Confidential records were stored in locked areas. Licensee also presented proof of current/active business liability insurance. No deficiencies were observed or cited during today's annual inspection. An exit interview was conducted with Sara, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit. Signature below confirms receipt of the documents. **NOTE: LPA left for an hour lunch break and returned to complete the inspection.