Routine inspection·May 8, 2023

Licensing Program Analyst (LPA) Victoria Bertozzi arrived unannounced to conduct an Annual Required inspection and was greeted by staff. Licensee, Christine Woltering arrived later. LPA initiated a tour of the facility around 9:20am and made the following observations: Facility was a comfortable temperature and passageways were free from obstructions. Residents rooms were furnished per regulation. Water temperature in bathrooms used by residents measured at 110 and 111 degrees F which is within the range of 105 to 120 degrees F allowed per regulation. Extra hygiene products and linens were available. Cabinet in kitchen containing cleaning supplies was locked. Facility has at least two days of perishable and one week of non-perishable foods which appeared to be of quality and stored per regulation. Medications were centrally stored and locked. Facility has emergency food and water supplies. Fire extinguisher was last serviced May 2022. Facility has hardwired smoke detectors located throughout the facility as well as a Carbon Monoxide detector that were tested and operational during inspection. Most recent disaster drill was conducted 3/2023. Three staff files and five resident files were reviewed. Staff have required First Aid and CPR certificates. Administrator Certificate for Administrator, Teresita M Astudillo 6001614735 expires 9/24/2024. Medications and medication records were reviewed. Continued on LIC809C Continued from LIC809 Licensee/Administrator to submit updates of the following documents by 6/08/2023: LIC 500 Personnel Summary Copy of Liability Insurance LIC 610 Emergency Disaster Plan (If changes) Infection Control Plan (If changes) No deficiencies cited during this inspection