Routine inspection·April 28, 2025

At approximately 9:30 AM, Licensing Program Analyst (LPA) Elias Magdaleno arrived unannounced to conduct a required 1-year annual inspection and was greeted by Steven Milton, Licensee. Facility is a Residential Care Facility for the Elderly (RCFE) with four (4) residents in care. Facility has a Dementia Care Plan, a Hospice waiver for two (2), with zero (0) Hospice residents currently in care, and is approved for all non-ambulatory residents. At approximately 9:45 AM, LPA initiated a tour of the facility with Licensee and observed the following: Facility is a one (1) story home, was a comfortable temperature, and passageways were free from obstructions. Fire extinguishers were last inspected 5/24. Smoke and Carbon Monoxide detectors were tested and operational during inspection. Water temperature measured 119.6 degrees F, which is within the allowable range of 105 to 120 degrees F per Title 22 regulations. LPA observed a supply of clean linens, hygiene, incontinent care, and paper products available for residents. Residents' bedrooms were inspected and observed to have all the appropriate furnishings as outlined in Title 22 regulations. Cabinets containing cleaning supplies and other items that could pose a risk were locked. LPA observed at least a two (2) day supply of perishable and seven (7) day supply of non-perishable food. Food was found to be stored in a safe manner with open items covered, as well as an emergency water supply. There is a shaded seating area in the backyard with outdoor space for activities. LPA observed board games, bingo, and an arcade Pac-Man station. LPA was informed that facility takes residents to church on Sundays and out to dinner, other outings are at the discretion of the residents. Facility telephone was tested and operational during inspection. Continued 809C... Continued from 809... At approximately 10:30 AM LPA conducted a review of four (4) resident records. All required documentation present. At approximately 11:15 AM LPA conducted review of two (2) staff records. All required documentation present. At approximately 11:40 AM LPA and Licensee conducted a spot check of medication and medication records. Medication is centrally stored and locked. Sheryl Milton Administrator Certificate 7010836740 renewal submitted 3/13/2025. All fees are current as of this time. LPA and Administrator discussed facility's Emergency Disaster plan, last updated 5/2024. Facility’s last monthly disaster drill was conducted on 4/25. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: Liability Insurance LIC500 - Personnel Report LIC308 - Designation of Responsibility LIC400 - Affidavit Regarding Client Cash Resources LIC610D - Emergency Disaster Plan No deficiencies cited. Exit interview conducted with Licensee and a copy of this report was given.