Routine inspection·September 30, 2025

On 09/30/2025, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA met with Staff Members (SM), Analiza Manganti and Michael Manganti and explained the purpose of the visit. LPA asked SM Maganti to call the Facility Designated Administrator (FDA), Maria Angelica Souxouay to inform her that CCL was present. Shortly after, FDA Souxouay arrived at the facility. This facility 6 residents, of which 5 may be non-ambulatory and 1 may be bedridden. This facility also has a dementia plan on file with a hospice waiver for 6 residents. Current census was 6. A brief interview with FDA Souxouay was conducted. A review of 3 staff files and 6 resident files were conducted. There are currently 4 residents on hospice. All files were current and up to date. The perspective facility administrator has an active administrator certificate #7034066740 and expires on 04/30/2027. A tour of the facility was conducted. Fire extinguisher located by the garage door appeared to have been serviced 07/07/2025 and is in compliance. The kitchen area was toured. LPA Pascua observed a sufficient seven days of non-perishable as well as two days worth of perishable food supplies in the main kitchen. Additional perishable supplies were identified in an additional refrigerator located in the garage. Knives and additional cleaning supplies were locked and made inaccessible to the residents at this time. LPA Pascua observed a locked centralized stored medication cabinet located in the dining room. Along with Administrator, the LPA observed, reviewed, and compared resident medication with the medication dispensing logs. First Aid Kit was present and contained all of the required components. Common areas were toured. Living room, dining area and all other areas intended for resident use were in compliance and good repair. A tour of the garage was conducted. Additional storage for supplies were stored in cabinets. A washer and dryer were also identified in the garage. Laundry detergent, bleach, and all other cleaning supplies were observed to be locked and made inaccessible to the residents at this time. A tour of the bathrooms was conducted. Hot water temperature was measured and observed to be within the required range of 105-120 degrees. Grab bars were present and in good repair. A tour of the resident bedrooms was conducted. Resident furniture was observed to be sufficient to meet the resident needs at this time. A linen closet was located in the hallway and presented a sufficient amount of linens to adequately supply and meet the needs of the residents at this time. Additional incontinence supplies were also identified. The exterior of the physical plant was in good repair with no hazards present. Perimeter fence was observed to be stable and gates were in good repair. The following forms and documents were requested to be updated and submitted into CCL. -LIC 308 -LIC 400 -LIC 500 -LIC 610 Based on the observations made during today's visit, there are no deficiencies were observed or cited during this annual visit. An exit interview was conducted and a copy of this report was given to Facility Designated Administrator.