Routine inspection·November 25, 2025

At approximately 12:00pm, Licensing Program Analyst (LPA) Contreras arrived unannounced to conduct a required annual inspection visit. LPA was greeted by Administrator Joy Johansen. Facility is a Residential Care Facility for the Elderly that has a fire clearance approved for a capacity of 3 non-ambulatory, of which 1 may be bedridden. Room 2 approved for bedridden resident and a hospice waiver for 2. Facility is a 2 story home with only first floor accessible for residents. There are currently 2 residents in care. LPA toured the building and grounds which was found to be clean and at a comfortable temperature. LPA observed all walkways and exits to be unobstructed. All required postings were in a highly visible area. Fire extinguishers were charged and last inspected 01/17/2025. Fire alarms and carbon monoxide detector were tested and operational. Outdoor emergency exit clear from obstruction. Outdoor furniture accessible for resident use. Water temperature measured at 116 and 110 degrees F at faucets accessible to residents which is within the allowable range of 105 to 120 degrees F. Disaster drills are conducted quarterly. All bedrooms were equipped with lighting, a night stand and chest of drawers. Resident bathroom observed to have bath mat and grab bar. Facility had an ample supply of linens, towels and extra hygiene products for residents. LPA observed at least a 2 day supply of perishable and 7 day supply of non-perishable foods. Emergency food was observed to meet the 72 hour emergency supply. Facility kitchen, refrigerators and freezers were clean, and food was stored properly with expiration dates noted. Toxins are locked and inaccessible to residents. Sharps and knives were locked in kitchen drawer. Continued onto 809C... continued from 809... LPA reviewed 3 staff records. All documentation found to be present. LPA reviewed 2 of 2 resident records. All required documentation was present. Physician reports were up to date. LPA and Admin conducted a spot check of medication and medication records, all records up to date. Medication is centrally stored and locked. Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit: LIC500- Personnel Report LIC308- Designation of Responsibility Liability Insurance No deficiencies given during todays visit. Exit interview conducted and report read with Administrator.