Routine inspection·August 28, 2025

At 8:45am, on 8/28/2025, Licensing Program Analyst (LPA) Haner-Tomasko arrived at the facility unannounced to conduct the annual facility inspection. LPA met with backup administrator Edwin Ingan, announced who he was and the reason for the visit. Backup Administrator and LPA conducted a full tour of the facility. This facility is a single story residential home with five resident bedrooms (one is dual occupancy), three full bathrooms (one is on-suite and two are for public/shared use). There is a living room, dining room, a kitchen and office area. Access to the laundry and garage is through a locked door for resident safety. LPA noted that the backyard and the front yard both have seating and shade for residents and visitors. LPA noted full bed rails on Resident #1's (R1's) bed and R1 does not meet the Title 22 regulations for full bed rails. The facility submitted an exception request for R1's full bed rails to Licensing on 8/8/2025. The facility has wired smoke detectors in each room that are all working and tested by Mid Coast Fire Protection, Inc on 6/2/2025, the carbon monoxide detector is in the office area and functioning normally. LPA observed a fire extinguisher near the dining room that was tagged current and in the green compression range, serviced on 3/10/2025. LPA tested facility hot water at 114.0*(f), within regulation temperatures 105*-120* (f). LPA observed at least 2 - days of perishable and at least 7 - days of nonperishable foods. LPA noted that the facility is clean and in good repair with no obstructions in hallways, doorways or exits. Medications are locked in the entry. Staff and client files are in the office area. LPA conducted a sample medication audit and reviewed the facilities Centrally Stored Medication Records, finding no violations. LPA conducted a staff and resident file review. (Continued on LIC809-C) LPA and Backup Administrator conducted a review of the annual care tool modules. There were no deficiencies cited at this time. Exit interview conducted, report signed, and report provided to Backup Administrator.