Routine inspection·March 24, 2025

Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced required Annual Inspection to the above-named facility. Upon arrival, LPA was greeted by Tharanganie Mohottigue, Administrator. Wasantha Mohottige arrived at approximately 1:50 PM. LPA inspected the one-story facility for fire safety, personal accommodations, and food service. Entrance interview conducted. There are currently five (5) residents residing in the facility. Currently, there is one resident on hospice, four (4) non-ambulatory residents and one (1) ambulatory resident. At the time of arrival, there was one (1) staff available in the facility, one Administrator, and five (5) residents present in the facility. LPA toured the facility with Administrator. LPA observed five (5) resident bedrooms, and one (1) staff bedroom. Bedrooms #1, 2, and 4 are private rooms with private bathrooms. Bedrooms 3 and 5 are private bedrooms with a shared bathroom off the hallway. Walls, floors, and doorways are clean with no safety hazards. The kitchen area consists of a countertop area, a refrigerator, a stove, a microwave, and a sink. Sharps and centrally stored medications are kept in a locked cabinet in the dining area with no access to residents. First aid kit was observed to be complete. Fire inspection was current as of 1/8/2025. There is a sufficient amount of perishables for two (2) days and non-perishables for seven (7) days. Emergency food is stored in a second refrigerator and pantry located in the garage. There is a washing machine and a clothes dryer in the garage. Chemicals and toxic substances are kept in a locked cabinet in the garage. Please continue to 809-C, Pg 2. The facility has nine (9) smoke alarms and one carbon monoxide detector all in good working order. The living room and dining area are neat and clean. The facility maintains a comfortable temperature. Hallways, bedroom doors and walls are in good repair. The living room and dining area are neat and clean. The facility maintains a comfortable temperature. Hallways, bedroom doors and walls are in good repair. The backyard consists of pebble embedded ramps, a picnic table, and fruit trees in a shaded area. The recycling bin, green waste bin, and trash bins are standard bins with flip lids. A tour of the physical environment and accommodations were assessed, and the following was noted: LPA observed the required posting of the complaint poster, Ombudsman contact, and Resident’s Rights. Residents may participate at will in activities such as personal care appointments, medical appointments, games, exercising, neighborhood walks, sitting on the patio, outdoor excursions to parks, beaches, and shopping at local retail businesses. Residents’ records were reviewed and all records are up-to-date. Record review revealed all medications are given as prescribed. Personnel records were reviewed and records and trainings are up-to-date. All persons associated with the facility have a criminal record clearance and have been properly associated to the facility. Administrator's certificate is current. Exit interview conducted. No deficiencies noted. Copy of report issued at the time of the visit.