Routine inspection·October 8, 2025

Licensing Program Analyst (LPA) Zabel Chochian conducted a required annual visit to this facility today. Upon arrival LPA met with caregiver, who called Administrator Mirvat Yacoub. LPA spoke with Administrator and informed her of the reason for todays visit. Ms. Yacob, arrived to the facility however was not able to stay for the annual visit. Assistant Administrator Janette Villapando was authorized to sign today’s report. At approximately, 11:30am, LPA toured the physical plant areas inside and outside to ensure there are no health and safety hazards and facility is in compliance with Title 22 Regulations. Required postings observed in the common area. The facility maintained a comfortable temperature of 75 degrees. Common spaces: The common areas were observed to be properly furnished at the time of the visit. Furniture was observed to be in good condition. Facility provides sufficient space to accommodate both indoor and outdoor activities. LPA observed a working phone available for residents use whenever needed. There is a fireplace in the Living Room, which was observed to be adequately screened. Bedrooms: The LPA observed the resident bedrooms, which were furnished appropriately with clean linens, appropriate furnishings and sufficient lighting. There are four (4) total bedrooms, two (2) shared and two (2) private, and one (1) staff room. Room #2 is cleared as a bedridden room. LPA observed that Room #2 is equipped with a fire door, and it has a direct exit to the backyard in case of an emergency. No bedroom was used as a passageway to another room, bath, or toilet. All rooms were free of odors. All window screens were clean and maintained in good repair. Bathrooms: Two (2) bathrooms. One (1) shared and one (1) in the master room, Room #1. Resident bathrooms were observed to be clean and sanitary and in operating condition with grab bars and non-skid surfaces. All bathrooms were supplied with appropriate paper and hygiene products. Hot water temperature was measured in all resident bathrooms and measured within the required range of 105 degrees Fahrenheit to 120 degrees Fahrenheit (109 -110.5*F) at the time of the visit. (Continue) Kitchen : Kitchen appliances appeared to be in operable condition. The facility has a sufficient supply of perishable and non-perishable food at the time of the visit. Food labels were inspected and checked for dates and expiration dates. Refrigerated and frozen foods were stored at proper temperature. Knives and sharps observed locked in a drawer next to the kitchen stove. Cleaning supplies were stored under the kitchen sink locked and inaccessible at the time of the visit. There were no pesticides or poisons observed near any food areas. Garage/Office: The garage is kept locked and inaccessible at all times. The garage is where the washer and dryer are held. Cleaning supplies and disinfectants are kept in locked cabinets in the garage all cleaning compounds were stored in areas separately from food supplies. The LPA observed another freezer in the garage with additional food. An adequate supply of emergency food and water was observed. In the garage there is an office area. Next to the office desk, there is a locked file cabinet where both staff and resident files are securely stored. Outdoor Space: The backyard area contains a shaded area with a table and chairs for resident use. There is one (1) side gate with self-latching mechanism and a working alarm. Passageways were observed to be clear and free of hazards. There were no bodies of water noted at the time of the visit. File review: At approximately 12P.M., LPA began review of resident records. LPA reviewed four (4) residents files for, but not limited to: appraisals, medical records, admissions agreement, consent forms. All files were in order at this time. At approximately 12:45P.M. five (5) personnel records including Administrator and Assistant Administrators’ files were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. All files were in order. During today’s visit, the LPA obtained copies of the following: LIC 500 Personnel Report, LIC 9020 Resident Roster, and a copy of limited liability insurance. Last emergency disaster drill was conducted on 07/15/2025. Fire extinguisher is fully charged, and recently serviced on 04/15/2025. Combination smoke and carbon monoxide detectors were tested at 2P.M. and were operational at this time. Medication review: Medications are centrally stored in a cabinet by the kitchen locked and inaccessible to residents in care. Medication review began at 2:15P.M.; LPA reviewed medication log for all four (4) residents. Medications are labeled and checked for expiration dates. Medications are properly documented on the centrally stored medications and destruction record. No deficiencies cited at this time. Exit interview conducted and copy of the report provided.