Routine inspection·October 27, 2025

Licensing Program Analyst (LPA) Zabel Chochian arrived at the facility to conduct a required annual visit. Upon arrival, LPA met with Administrator, Kim Anderson and the reason for the visit was explained. Entrance interview conducted. At 1:45 p.m., the LPA along with the Administrator 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. KITCHEN: The kitchen appeared clean and the appliances and fixtures functional. Refrigerated and frozen foods were stored at proper temperature. There was a sufficient amount of two (2) day perishable and seven (7) day non-perishable food. Food labels observed and checked for dates and expiration dates. Food had labels clearly marked with dates. Knives and sharps were observed locked in a drawer. Cleaning supplies were stored under the kitchen sink locked and inaccessible. There were no pesticides or poisons observed near any food areas. LIVING ROOM/DINING ROOM: The common areas were observed to be properly furnished and relatively clean at the time of the visit. Furniture was observed to be in good condition. Fireplace was observed to be adequately screened at the time of the visit. The facility maintained a comfortable temperature. Fire extinguishers were observed fully charged and purchased in 06/2025. The LPA observed required postings throughout the common spaces. The facility has a working telephone on premises. Auditory alarms on all doors were functional at the time of the visit. Entry/exits were free of obstruction. There is a washer and dryer on the premises. Activities were observed in the common areas. BEDROOMS: There are six (6) resident bedrooms. The resident bedrooms were properly furnished with a bed, night stand, and sufficient lighting for each resident. The bedrooms had appropriate and adequate bedding and linens such as sheets, pillowcases, mattress pads, and blankets. There is one (1) staff bedroom that is locked at all times. (Continue to LIC809c) BATHROOMS: There are five (5) total bathrooms, three (3) for resident use, one (1) staff/guest and one (1) in the staff room. Resident bathrooms were clean and sanitary and in operating condition with grab bars and non-skid surfaces. The hot water was measured in each bathroom ranging within 105 - 120 degrees Fahrenheit. GARAGE/OUTDOORS: Garage access is from the outside; is kept locked and inaccessible at all times. Refrigerators observed with additional food. An adequate supply of emergency food and water was observed. Sufficient supply of Personal Protectant Equipment (PPE) observed. Cleaning supplies and toxins were observed in the garage inaccessible to residents in care. The backyard has a shaded area with furniture for resident use. The LPA observed one gate that self-latches with a clear passageway in case of an emergency on one side of the house. There were no bodies of water noted at the time of the visit. RECORDS: Records review began at 2:15 p.m., three (3) resident records were reviewed for, but not limited to: appraisals, medical records, admissions agreement, consent forms. All files were in order at this time. Four (4) Personnel records and Administrator’s file were reviewed for, but not limited to: personnel records, health assessments, criminal record clearances, first aid/CPR training, and the appropriate training. MEDICATIONS: Medications review began at approximately 3:30 p.m. Medications are centrally stored in a cabinet by the kitchen locked and inaccessible to residents in care. All medications including PRNs were labeled, stored, and locked inaccessible to residents. PRNs have physicians order on file. Medications are labeled and checked for expiration dates. At approximately 4:30 p.m., the smoke detector(s) and carbon monoxide detectors were tested and observed operational during todays visit. INFECTION CONTROL/EMERGENCY DISASTER PLANNING: During today’s visit, the LPA reviewed the facility's infection control practices and the facility's emergency disaster plan. The facility’s policies and procedures as it pertains to infection control are adequate. Emergency disaster plan is updated annually as required. Emergency disaster drills are conducted quarterly as is required, with the last drill conducted on 09/18/2025. No deficiencies cited at this time. Exit interview conducted. A copy of the report was provided.