Routine inspection·June 22, 2023

Licensing Program Analyst Ryker Heberle (LPA) conducted an unannounced annual inspection. LPA met with facility administrator Frances Grace Locsin (Admin). LPA toured the facility, including living room, kitchen, dining room, 5 resident bedrooms, 1 staff bedroom, 2 bathrooms, garage, laundry room and back yard. Admin confirmed that all staff and residents have been vaccinated. Facility Infection Control plan has already been submitted. No prohibited items noted in resident rooms. All emergency exits noted to be clear of obstruction. All rooms in facility noted to be clean and well maintained. Hand sanitizers, soap, and paper supplies were observed to be available. At least 2 days' supply of perishable food and at least 1 week's supply of non-perishable food was observed on the premises. Smoke/carbon monoxide detectors were observed to be operational. Water temperature observed to be 119.5 *F. Fire extinguisher observed to have been inspected on June 2023. LPA inspected resident and staff files and medication cabinet. No missing medications or files were observed for residents or staff. Medication administration records were up to date and medication lists observed to contain all necessary corresponding information as observed on medication labels. Facility file observed to have all necessary information and documents. All residents interviewed stated that they have no issues with the facility and that they receive all their meals and medications on time. No deficiencies cited during today's visit. This report was reviewed with facility Administrator Frances Grace Locsin and a copy of the signed report was provided.