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25 | On 12/10/25 Licensing Program Analyst (LPA) Villegas conducted an unannounced visit to the above facility. LPA met with staff Maria..... as the purpose of the visit was explained. Facility is licensed to serve 6 ambulatory residents of which 6 may be non-ambulatory. The facility has an approved hospice waiver for 6. Facility fees info and pin were provided to staff (due date: 12/31/25 Balance: $495). Liability insurance is active (PC199445579-01 EXP: 01/22/26).
The home is a single story home consisting of: (4) resident bedrooms, (1) full bathroom, 1 staff bathroom, den, living room, kitchen with dining area, laundry room (located in the attached garage), an outdoor shaded patio area, there are no bodies of water on the premises. A land line was observed. LPA toured the resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. The resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place, water temperature measured between 105F- 120F.. Perishable and non-perishable food supply was checked, all cleaning solutions, hazardous items, and medications were securely locked and inaccessible to residents. Smoke detectors and carbon monoxide detectors were working properly, and fire extinguisher was fully charged. Emergency drill conducted on 12/09/25, first Aid kit and manual were available.
LPA conducted a records review of (5) resident records, (5) resident Medication Administration Records, and (4) staff records.
Exit interview conducted, and a copy of this report was provided.
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