Routine inspection·October 15, 2025

Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced required Annual Inspection at the facility. LPA met with Asel Telman, Administrator and explained the purpose of the visit. Entrance Interview Conducted: The facility is a one-story Residential Care Facility for the Elderly (RCFE). The facility has been approved for six non-ambulatory residents of which two may be bedridden and maintains a hospice waiver for six residents. There are currently 6 residents residing in the facility. Upon arrival, there were five residents in care with one caregiver and one administrator on duty. Three (3) residents are currently on hospice. The facility consists of a living room, dining area, kitchen, and five bedrooms. Upon entrance, there is a walkway leading to the front door and garden areas. The front porch has a covered patio with available seating. The facility has a locked garage used for storage including the facility’s commercial generator. There are no fountains or bodies of water. The entrance into the residence leads into the common living area from a hallway. The kitchen consists of a refrigerator, microwave, sink, stove, oven, dishwasher, and a toaster. Trash and recycling bins are kept in a pullout drawer. All required CCL posters and signage are posted near the entrance and in the hallway. Personnel files, Residents’ files, and medications are kept in locked cabinets in the kitchen area. All files and medications are inaccessible to residents in care. Sharps are kept in a locked kitchen drawer and are inaccessible to residents in care. Perishable foods for 2 days and non-perishable foods for 7 days are kept on hand for the residents. The living room and dining area are furnished with adequate furnishings to sustain a capacity of six residents. First aid kits and a locked first aid supply cabinet are kept in the built-in locked cabinets located in the hallway. Please continue to 809-C, Pg 2 Bedroom 1 is a shared bedroom with a shared private bath. Bedrooms 2 and 3 are private bedrooms with private bathrooms. Bedrooms 4 and 5 are private bedrooms and share a bathroom off the hallway. Each bathroom has a sink, commode, and showers with grab bars. Bedrooms 1 and 5 have been designated as bedridden bedrooms. Each bedridden bedroom has an exit/entrance door leading to the outdoor areas. Each exit/entrance door has a functioning door alarm. Each resident’s bedroom has a bed, mattress, nightstand, chair, dresser, closet, and a motion detector for movement. Overhead lighting and lamps on the nightstands provide sufficient lighting in each bedroom. Hallways have night lights and ample lighting. The laundry area and storage area for cleaning agents and chemicals is located in the locked garage. The backyard consists of an umbrella, fenced, patio area with chairs and tables. The patio has built-in garden planters and walkways. The trash, recycling, and green waste cans are standardized cans located outside the facility. There is a hard-wired dual carbon monoxide detector and smoke alarm system in every room and every hallway. There are three fire extinguishers that were serviced on 2/18/2025. The fire extinguishers are located near the common area close to the bedrooms, kitchen, hallway, and in the garage. LPA observed the facility’s comfortable room temperature upon arrival. Residents’ records, personnel documents and records of confidentiality are kept in a locked closet located in the kitchen area. Residents records were reviewed. Admission agreements, needs and services plans, health screenings, and emergency contact information was on file and up to date for each resident. Medications are administered per Doctor’s orders. Residents participate at will in various activities based on their individual interests and preferences, including bird watching, musical activities, joyful movement, and games (Dominoes, Bingo, and many others). Exercise classes on the premises are provided for the residents that include physical therapy, music, and singing. Residents participate at will in outdoor activities such as spiritual/worship, socializing with family and friends, leisure drives and walks, and outside exercise. Volunteers from community organizations will assist residents in reading, arts and crafts activities, games, and seasonal celebrations. Please continue to 809-C, Pg 3. Administrator’s certificate is current. Staff records reviewed with all trainings, health screenings, and personnel documents are current. All staff have received a criminal background clearance and are associated to the facility. Exit interview conducted. No deficiencies noted; no citations issued. Copy of report issued at the time of the visit.