Routine inspection·May 11, 2026

Licensing Program Analyst (LPA) Rankin arrived at 9:04 a.m. to conduct a 1-year annual visit to the facility above. LPA met with Patricia Hernandez and Reyna Espinosa 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 is a 4 bedroom and 2 bathrooms. The facility occupies 4 residents and employs 7 staff of which one is the Administrator. The facility is clean, safe and sanitary. The facility has smoke and carbon monoxide detectors which were tested and working properly at time of inspection. The lighting and lamps are sufficient for the use of the facility and for resident comfort and safety. The showers have non-skid mats. Toilet, hand washing and bathing facilities are operational and secured grab bars are present. The pathways are clear of any obstructions. Disinfectant, cleaning solutions and poisons are inaccessible to residents. The facility has sufficient space inside and outside for activities and visiting. The facility has a backyard for client use with furniture and plenty of shade. 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 09/15/26. The facility is approved for a capacity of 6 non-ambulatory and approved for hospice waiver of 3. Staffing, Personnel Records & Training: Staff records are kept confidential. LPA reviewed 5 staff files. Files reviewed had current 1st Aid/CPR, Personnel Records/Application, Health screening with TB results, Criminal Record statements, and Fingerprint clearance/Associations/exemptions. Administrator Certificate expires on 01/01/28. All files were kept up to date with all requirements being met. LPA reviewed staff training records for Annual Training Requirements of 20 plus hours additional training was scheduled and will be completed by end of week. Continued 809-C Resident Records & Incident Reports: The facility keeps separate files on each resident confidential. Four (4) files were reviewed for signed Admission Agreements, Medical Assessments, LIC 602A Physicians Report, ID and Emergency contact forms, Appraisal Needs and Services plans (ANS), TB results, Personal Rights, and Safeguard for personal property and valuables. The facility does not handle cash resources. Incidental Medical & Dental : The facility has a medication that is kept locked. Facility provides or assist in providing transportation to medical and dental appointments when needed. 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 reviewed a sampling of residents’ medications, no medications labels were altered, no expired medications, and medications were stored in original containers. Food Service: The facility handles and prepares food safely. The facility has 2-day perishables and 7 day non-perishables to meet the food service requirement. Kitchen areas are kept clean and free insects and pests. Disaster Preparedness : The current emergency disaster forms were reviewed. The facility conducts quarterly disaster drills. The fire extinguishers were charged last 7/9/25. Emergency exits and telephone numbers were posted. A set of keys is available for staff on all shifts to access full facility in an emergency. Residents with Special Health Needs: The facility does accept dementia residents in care. All items that could pose a danger, sharps, cleaners were inaccessible to residents in care. The facility does not have delayed egress. The facility does not currently have residents with oxygen. The facility has 1 residents currently on Home Health services. Home Health services records are kept on file. The facility has 2 residents on hospice, all records kept on file. The facility gate is self-latching. The backyard is completely fenced. The facility has exiting door alarms, which were working on LPA's visit. Exit interview conducted and copy of report printed for Administrator.