Routine inspection·April 2, 2026

Licensing Program Analyst (LPA) Rankin arrived at 12:17 pm to conduct a 1-year annual visit to the facility above. LPA met Administrator Aurea Alejandro and explained the purpose of the visit. A tour of the inside and outside of the facility was conducted with Administrator. The following was inspected and noted during the annual visit: Physical Plant & Environment Safety: The facility has 4 bedrooms and 2 bathrooms, with 1 bedroom dedicated to staff. The facility occupies 2 residents and employs 3 staff of which one is the Administrator and back-up are available if needed. The facility has smoke and carbon monoxide detectors; both were tested and were working at the time of visit. The lighting and lamps are sufficient for the use of the facility and for resident comfort and safety. The facility kitchen is clean, safe and sanitary. Toilet, hand washing and bathing facilities are operational and secured grab bars are present. The pathways are clear of any obstructions. Disinfectants, cleaning solutions and poisons are inaccessible to residents in care. The facility has sufficient space inside and outside for activities and visiting. Operational Requirements: The facility has a current plan of operation on file. The Facility is operating in compliance with the granted fire clearance. The facility has current liability insurance and expires on 02/28/2027. The facility is approved for a capacity of 6 non-ambulatory of which 1 may be bedridden. Staffing/Personnel Records & Training: Staff records are kept confidential. LPA reviewed 3 staff files. Files reviewed were kept up to date with all requirements. LPA reviewed training records for Annual Training Requirements, all required annual training was documented. Administrator Certificate expires 3/11/28. Continued 809-C Resident Records & Incident Reports: Two files were reviewed for signed Admission Agreements, Medical Assessments, LIC. 602A Physicians Report, ID and Emergency contact forms, TB results, Pre-appraisal, and Safeguard for personal property and valuables. Incidental Medical & Dental : The facility has a medication cabinet which was and is kept locked. The medications records were reviewed and all residents in care had a Medication Administration Record (MAR) and a Centrally Stored Medication Destruction Record (CSMDR). LPA inspected all residents medication and PRN medications. PRN logs and authorization forms were present. No medications labels were altered, and no expired medications. Food Service: The facility has 2-day perishables and 7 day non-perishables to meet the food service requirement. All food is covered, stored and marked appropriately. Food, snacks and drinks are available when the residents want them. Emergency supply of food and water is available. Kitchen areas are kept clean and free from litter, rodents, and insects. Disaster Preparedness : The current emergency disaster forms were posted, LPA reviewed and collected current copy of plan. The facility conducts quarterly disaster drills. The fire extinguisher was charged. Emergency exits and telephone numbers were posted. Residents with Special Health Needs: The facility does accept dementia residents in care. All items that could pose a danger, sharps, cleaners were locked or in accessible to residents in care. The facility does not have delayed egress. The facility does has one resident on PRN Oxygen which a notification for the fire department was recorded in their file. There is one resident on hospice and one resident with home health services. The facility gates are self-closing and self-latching. The backyard is completely fenced. Exit interview conducted and copy of report printed for Administrator.