Facility Evaluation Report

On 5/24/2025, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required inspection. LPA introduced self, stated purpose of visit, and allowed entrance by Direct Care Staff. LPA met with Registered Nurse (RN), Gurpiar "Garry" Brar to commence inspection. Administrator, StacyRae,Agusto contacted by telephone and arrived a short time later to continue with inspection visit.

LPA conducted facility with RN. There are currently 5 residents residing in home. LPA observed all residents to be participating in activities with staff during inspection visit. All common areas of facility have adequate seating available All bedrooms for residents are private, bedrooms observed to have all required furnishings. Resident bathrooms toured, LPA observed bathrooms to have grab bars available, water temperature observed at 109 degrees F. Kitchen toured, facility observed to a 2-day supply of perishable and a 7-day supply of non-perishable food available. All knives observed to be locked and secured in kitchen cabinet. LPA observed 2 medication carts which are locked and secured. LPA observed the medical supply room and cleaning supply room to both be locked, secured, and inaccessible to residents.

Fire extinguishers present throughout facility with a service date of 2/28/2025. Smoke detectors and carbon monoxide detectors present and observed operational during inspection. Facility is equipped with sprinkler system. The last disaster drill and fire drill was conducted on 5/01/25 according to facility records.

Outside of facility toured. Facility has a shaded patio area with seating available. All exits open free of obstruction. No hazards observed.

Staff and resident files reviewed. No deficiencies observed or cited during today's inspection.